Small Intestine

C17WHO Vol. 1

Digestive System

Prognosis

This section is being prepared by our editorial process.

🔬 Histological Types

📚 Latest Research

2026-09-10

Four Radical Bowel-Sparing Procedures for the Treatment of Small Bowel Tumors: A Retrospective Cohort Study From a Prospective Clinical Trial.

Ignjatovic D, et al

A new artery-based surgical framework comprising four bowel-sparing procedures for small bowel tumors achieves standardized D3-volume lymphadenectomy with a median lymph node harvest of 31 (median D3-lymph node harvest of 12) and zero 30- or 90-day mortality in a cohort of 86 patients. Using preoperative 3D vascular reconstruction to identify tumor-feeding arteries, surgeons selected among duodenojejunal resection, jejunal resection, ileal resection, or right colectomy/ileocaecal resection, achieving a median specimen length of only 31.5 cm. Positive lymph nodes were identified in 71 of 86 patients, with D3 positivity confirmed in 33, demonstrating that oncologically adequate nodal staging can be accomplished while limiting resection length and thereby reducing the risk of short bowel syndrome.

Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract

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2026-09-09

AGA Clinical Practice Update on Management of Ampullary Neoplasms: Expert Review.

Barakat M, et al

The American Gastroenterological Association has issued a Clinical Practice Update establishing best-practice guidance for the management of ampullary neoplasms, a rare cancer accounting for 0.6%–0.8% of gastrointestinal malignancies whose incidence in young adults has increased over the past 20 years. A central finding driving the guidance is that 20%–40% of ampullary adenomas already harbor malignancy at the time of diagnosis, underscoring the need for at least 6 targeted biopsies per lesion, particularly from ulcerated or indurated areas. The five-year survival rate for ampullary cancer ranges widely from 20% to 75% depending on stage at diagnosis, making early, high-quality endoscopic assessment and complete resection critical to improving patient outcomes. Key technical recommendations include the mandatory use of a side-viewing duodenoscope for evaluation and endoscopic ultrasound for staging prior to resection of potentially amenable lesions.

Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association

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2026-09-07

Cold Resection for Superficial Non-Ampullary Duodenal Epithelial Tumors: Current Evidence and Clinical Perspectives.

Mikuriya Y, et al

A new narrative review published in DEN Open establishes cold snare polypectomy (CSP) as the principal cold resection technique for superficial non-ampullary duodenal epithelial tumors (SNADETs) smaller than 10 mm that are optically diagnosed as low-grade adenomas using white-light imaging and narrow-band imaging. The review individually appraised three cold techniques — CSP, cold forceps polypectomy (CFP), and cold snare endoscopic mucosal resection (CS-EMR) — finding CSP to be technically feasible and safe, with available follow-up data indicating low recurrence rates and recurrent lesions that are generally small and endoscopically manageable, despite a shallow resection depth that limits vertical margin assessment. CFP was deemed acceptable only for carefully selected diminutive lesions with limited supporting evidence, while CS-EMR was discouraged for routine use due to substantial recurrence rates and a reported risk of perforation. These conclusions provide clinicians with a structured framework for individualizing treatment — including structured surveillance as an alternative to immediate resection for selected small low-grade adenomas — while avoiding electrocautery-related injury in the anatomically distinctive, thin-walled duodenum.

DEN open

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