Post written by Anand R. Kumar, MD, MPH, FASGE, from Thomas Jefferson University, Philadelphia, Pennsylvania, USA.

We combined ERCP and endoscopic submucosal dissection techniques to resect a large periampullary duodenal paraganglioma.

This was a unique case where the biliary and pancreatic openings could be moved away from the paraganglioma with ERCP and protected during endoscopic resection.

Endoscopists can tailor the approach to resection of periampullary lesions based on ampullary anatomy and relationship of the lesion to the ampulla.

Thank you for giving us the opportunity to highlight our video!

Movement of the biliary (B) and pancreatic (P) openings after sphincterotomy with a clear plane of resection (dotted line) via endoscopic submucosal dissection.

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