Endoscopic submucosal exavation for the treatment of gastric heterotopic pancreas        ZHONG Yun-shi, SHI Qiang, YAO Li-qing, et al. Endoscopy Center，Zhongshan Hospital，Fudan University; Endoscopy Research Institute，Fudan University, Shanghai200032, China
Corresponding author：YAO Li-qing, E-mail:yao.liqing@zs-hospital.sh.cn
Abstract    Objective    To evaluate endoscopic submucosal exavation(ESE) in the treatment of heterotopic pancreas in stomach．Methods    The clinical data of 60 cases of gastric heterotopic pancreas diagnosed by pathology between August 2007 and December 2010 in Endoscopy Center, Zhongshan Hospital of Fudan University were analyzed retrospectively．The cases were all treated with ESE, and the effects and safety were evaluated. Results    Heterotopic pancreas were most commonly found in gastric antrum (51/60，85%) and greater gastric curvature (34/60, 56.7%). Twenty-three cases（38.3%）were found a hollow in the top. EUS found that 2 cases（3.3%）were originated from muscular layer of mucosa, 42 cases（70%）from submucosa layer, 16 cases（26.7%） from muscle propria. En-bloc resection rate was 98.3%（59/60）. During ESE, arterial hemorrhage happened in 9 cases （15%）, which could be controlled by electric coagulation forceps or metal clips. Pneumoperitoneum was found in 12 cases（20%）. There was no patient converted to surgery due to complications. During a median follow-up of 17 (4-44) months, no recurrence was found. Conclusion    ESE is a method not only to get the exact pathologic diagnosis but also to meet with principle of the local resection for heterotopic pancreas. It is safe, effective and worthy of spreading.