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re 1. A, Endoscopic assessment of duodenal laterally spreading lesion (LSL). B, Involvement of ampulla of Vater. C, D, Sequential endoscopic resecof laterally spreading component. E, F, Complete endoscopic mucosal resection of LSL and ampullectomy. G, First surveillance endoscopic view ing small diminutive polyp recurrence of LSL component. H, Surveillance endoscopic view showing no recurrence at the ampullectomy site. en transcript of the video audio is available online at www.VideoGIE.org.

EMR of large laterally spreading lesion of the duodenum involving the ampulla