A new pre-closure technique for endoscopic papillectomy significantly lowers delayed bleeding risk in duodenal papilla adenoma patients.

• Delayed bleeding rate was 0% with pre-closure vs. 17.95% without (p = 0.017).
• Immediate bleeding rate decreased from 66.67% to 37.93% (p = 0.027).

This approach also shortens hospital stays: 6 days vs. 7 days (p = 0.048).

• Cannulation time improved to 6 minutes from 8 minutes (p = 0.026).