Surgical Management of Peutz-Jeghers Syndrome When Endoscopy Is Not Enough
Peutz-Jeghers syndrome is associated with gastrointestinal polyposis that frequently requires active intervention. Endoscopic management addresses many cases, but a subset of patients present with polyps that fall outside what endoscopy alone can safely handle.
This protocol covers the management of polyps in Peutz-Jeghers syndrome that cannot be treated endoscopically — including polyps that are exceptionally large, difficult to resect, or anatomically inaccessible by balloon-assisted enteroscopy (BAE).
When endoscopic treatment is insufficient, structured surgical intervention is indicated. Approaches that combine operative access with endoscopic techniques during the same procedure may be considered in select cases. The complete decision algorithm and procedural stepwise guidance are available in the full protocol.
References
DOI: 10.1159/000529799
Surgical resection is required for polyps that cannot be treated endoscopically.
When polyps are exceptionally large and difficult to resect or cannot be reached by BAE, intraoperative endoscopic polypectomy or removal through an intestinal incision should be considered.
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