Few studies have assessed the safety and efficacy of endoscopic resection for duodenal carcinoid tumors. This study aimed to evaluate the utility of endoscopic resection in this setting.

Between February 2015 and February 2024, 35 patients with sporadic duodenal carcinoids managed by endoscopic resection were enrolled. Endoscopic treatment was performed in patients without nodal or distant metastasis. Rates of endoscopic complete resection, histologic complete resection, procedure-related complications, and tumor recurrence were retrospectively analyzed.

Twenty-five nonampullary duodenal carcinoids were treated with endoscopic mucosal resection, four with endoscopic submucosal dissection (ESD), and six ampullary carcinoids with snare papillectomy. The mean patient age was 61.9 years (range, 44–83). Mean tumor size was 8.8 ± 2.4 mm (range, 3–12) for nonampullary carcinoids and 13.7 ± 5.4 mm (range, 5–20) for ampullary carcinoids.

The endoscopic complete resection rate was 97.1%. Incomplete resection occurred in one patient undergoing ESD due to tumor invasion into the muscularis propria. Histologic complete resection was achieved in 31 of 35 patients (88.6%) on the initial attempt; one additional patient required a second session to achieve complete resection.

Procedure-related perforation occurred in three patients with nonampullary carcinoids (8.6%): two were managed endoscopically, and one required local surgical excision. After a median follow-up of 39 months (range, 10–96), local recurrence was observed in one patient (2.8%) with a nonampullary tumor larger than 10 mm. Among patients with ampullary carcinoids, no local recurrence or distant metastasis was detected during a median follow-up of 40 months (range, 18–100).

Endoscopic resection appears to be a safe and effective treatment option for small (≤10 mm) nonampullary duodenal carcinoids without evidence of muscularis propria invasion. For ampullary carcinoids <20 mm confined to the submucosa, minimally invasive endoscopic papillectomy may be considered, particularly in older patients or those with significant comorbidities who are at higher risk for postoperative complications.