Cold snare polypectomy for duodenal adenomas in familial adenomatous polyposis: a prospective international cohort study

Aims Most patients with familial adenomatous polyposis (FAP) develop duodenal adenomas, but only 4-10% duodenal cancer. In an attempt to prevent cancer or prevent/delay duodenal surgery, endoscopic polypectomy is recommended. Adverse events (AEs) after duodenal polypectomy in the duodenum polypectomy include 2-3% perforation and 13-20% delayed bleeding, but these data are largely from hot snare polypectomy. We hypothesized that cold snare polypectomy (CSP) is a safe technique for superficial non-ampullary duodenal adenomas in FAP and reviewed our outcomes from CSP.