Duodenal endoscopic submucosal dissection using dual-channel rapid hemostasis for a large tumor involving the papilla

Duodenal endoscopic submucosal dissection (ESD) is a challenging procedure for large tumors involving the papilla [1]. We previously reported a dual-channel rapid hemostasis (RH) technique using a gas-free immersion (GFI) system that effectively stopped bleeding during gastric ESD with saline immersion [2] [3]. This method involves performing ESD using a double-channel endoscope (GIF-2TQ260M; Olympus), with hemostatic forceps pre-inserted into one of the accessory channels. Here, we present a case of a large duodenal tumor involving the papilla, in which ESD was performed using this method.