Abstract Effective strategies to prevent delayed bleeding (DB) following endoscopic mucosal resection (EMR) for large superficial non-ampullary duodenal tumors (SNADTs) remain limited. Octreotide exerts pharmacological effects that may influence hemostasis and thereby reduce bleeding risk. This exploratory study aimed to evaluate the association between postprocedural octreotide use and DB after duodenal EMR for large SNADTs. This single-center, exploratory, retrospective study included all hot EMRs for large SNADTs ≥ 10 mm (2015–2024). Routine post-procedural intravenous octreotide (50 μg/h) was introduced in 2022, administered immediately post-EMR at 50 μg/hour during overnight observation. DB was defined as clinically significant bleeding within 30 days requiring prolonged hospitalization, readmission, or intervention. A total of 107 SNADTs (median diameter 25 mm; interquartile range 15–40) were resected, including 33 treated with octreotide. Overall, DB occurred in 20% of patients (21/107), including 24% (18/74) in the control group and 9% (3/33) in the octreotide group. In logistic regression adjusting for lesion size and propensity score, octreotide showed a non-significant trend toward reduced DB overall (odds ratio OR 0.34; 95% confidence interval CI 0.08–1.17; P = 0.11). In the subgroup of lesions ≥ 30 mm, octreotide use was associated with a significantly lower odds of DB (OR 0.21; 95% CI 0.039–0.89; P = 0.045), whereas this association was not observed in smaller lesions. In this exploratory study, postprocedural intravenous octreotide appeared to be associated with a lower occurrence of DB after EMR for large SNADTs (≥ 30 mm). Larger, prospective studies are warranted to confirm these findings.
Leur et al. (Thu,) studied this question.