Introduction Ischaemic polypectomy with detachable-snares or endoclips at double-balloon enteroscopy (DBE) is emerging as a promising technique for the minimally-invasive management of small-bowel polyps in patients with Peutz-Jeghers syndrome (PJS).

Methods The aim of our study was to review our experience of ischaemic polypectomies in patients with PJS from July 2017 to November 2020. Demographic, endoscopic, histopathological data were analysed.

Results In this case series, 46 polyps were treated during 9 therapeutic DBEs (6 anterograde and 3 retrograde) performed in 4 patients (3 male and 1 female). Seven polyps >20mm in size required loop ligation with a detachable-snare. The majority of the small bowel polyps (39 lesions) were <20mm and were treated successfully with the double-clipping technique. No immediate or late adverse events occurred. All patients remained asymptomatic during follow-up (mean 19; range 1-48 months). None required subsequent surgery.

Conclusions Ischaemic polypectomy facilitated by DBE appears to be a safe and effective endotherapeutic option for endotherapy of small-bowel polyps in patients with PJS.