Skip to main content
SpringerLink
Log in

Segmental Duodenal Resection: Indications, Surgical Techniques and Postoperative Outcomes

  • Original Article
  • Published:
Journal of Gastrointestinal Surgery Aims and scope

Abstract

Introduction

Segmental duodenal resections (DR) have been increasingly performed for the treatment of primary duodenal tumours. The aim of the study is to review the indications for, clinical and operative details, and outcomes of patients undergoing elective DR.

Material and Methods

We retrospectively reviewed all patients who underwent elective segmental DR for the treatment of primary duodenal tumours, at a single institution between January 2007 and December 2013. Demographic data, clinical presentation, preoperative investigations, operative details, postoperative complications/mortality and histopathological results were recorded.

Results

In the study period, 11 duodenal resections were performed (7 male, median age 61 years). Thirty-six percent of the patients presented with anaemia. Surgical resection included two or more segments in seven patients. The most frequently resected part of the duodenum was segment 3 (n = 7). Median operative time was 191 min and blood loss was 675 ml. End-to-end and end-to-side anastomoses were performed in equal numbers. The pathology of resected specimens included adenocarcinoma (n = 4), gastrointestinal stromal tumour (GIST) (n = 1), adenoma (n = 5) and lymphoma (n = 1). Median hospital stay was 14 days. Overall, 30-day morbidity rate was 82 % (78 % Clavien 2 or less).

Conclusions

Segmental duodenal resection is a safe and effective surgical technique for the resection of primary duodenal tumours.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Kujath, P., O. Schwandner, and H.P. Bruch, Morbidity and mortality of perforated peptic gastroduodenal ulcer following emergency surgery. Langenbecks Arch Surg, 2002. 387(7-8): p. 298-302.

    Article  CAS  PubMed  Google Scholar 

  2. Sachdeva, A.K., H.A. Zaren, and B. Sigel, Surgical treatment of peptic ulcer disease. Med Clin North Am, 1991. 75(4): p. 999-1012.

    CAS  PubMed  Google Scholar 

  3. Degiannis, E. and K. Boffard, Duodenal injuries. Br J Surg, 2000. 87(11): p. 1473-9.

    Article  CAS  PubMed  Google Scholar 

  4. Zhou, B., et al., Pancreaticoduodenectomy versus local resection in the treatment of gastrointestinal stromal tumors of the duodenum. World J Surg Oncol, 2013. 11: p. 196.

    Article  PubMed Central  PubMed  Google Scholar 

  5. Sista, F., et al., Adenocarcinoma of the third duodenal portion: Case report and review of literature. World J Gastrointest Surg, 2012. 4(1): p. 23-6.

    Article  PubMed Central  PubMed  Google Scholar 

  6. Adler, D.G., et al., The role of endoscopy in ampullary and duodenal adenomas. Gastrointest Endosc, 2006. 64(6): p. 849-54.

    Article  PubMed  Google Scholar 

  7. Hoeppner, J., et al., Limited resection for duodenal gastrointestinal stromal tumors: Surgical management and clinical outcome. World J Gastrointest Surg, 2013. 5(2): p. 16-21.

    Article  PubMed Central  PubMed  Google Scholar 

  8. Johnston, F.M., et al., Presentation and management of gastrointestinal stromal tumors of the duodenum: a multi-institutional analysis. Ann Surg Oncol, 2012. 19(11): p. 3351-60.

    Article  PubMed  Google Scholar 

  9. Bourgouin, S., et al., Duodenal gastrointestinal stromal tumors (GISTs): arguments for conservative surgery. J Gastrointest Surg, 2013. 17(3): p. 482-7.

    Article  PubMed  Google Scholar 

  10. El-Gendi, A., S. El-Gendi, and M. El-Gendi, Feasibility and oncological outcomes of limited duodenal resection in patients with primary nonmetastatic duodenal GIST. J Gastrointest Surg, 2012. 16(12): p. 2197-202.

    Article  PubMed  Google Scholar 

  11. Kamath, A.S., et al., Gastrointestinal stromal tumour of the duodenum: single institution experience. HPB (Oxford), 2012. 14(11): p. 772-6.

    Article  Google Scholar 

  12. Liang, X., et al., Gastrointestinal stromal tumors of the duodenum: surgical management and survival results. World J Gastroenterol, 2013. 19(36): p. 6000-10.

    Article  PubMed Central  PubMed  Google Scholar 

  13. Yamashita, S., et al., Pancreas-sparing duodenectomy for gastrointestinal stromal tumor. Am J Surg, 2014. 207(4): p. 578-83.

    Article  PubMed  Google Scholar 

  14. Agrawal, S., et al., Surgical management and outcome in primary adenocarcinoma of the small bowel. Ann Surg Oncol, 2007. 14(8): p. 2263-9.

    Article  PubMed  Google Scholar 

  15. Bakaeen, F.G., et al., What prognostic factors are important in duodenal adenocarcinoma? Arch Surg, 2000. 135(6): p. 635-41; discussion 641-2.

    Article  CAS  PubMed  Google Scholar 

  16. Kaklamanos, I.G., et al., Extent of resection in the management of duodenal adenocarcinoma. Am J Surg, 2000. 179(1): p. 37-41.

    Article  CAS  PubMed  Google Scholar 

  17. Han, S.L., et al., The surgical treatment and outcome for primary duodenal adenocarcinoma. J Gastrointest Cancer, 2010. 41(4): p. 243-7.

    Article  PubMed  Google Scholar 

  18. Tocchi, A., et al., Adenocarcinoma of the third and fourth portions of the duodenum: results of surgical treatment. Arch Surg, 2003. 138(1): p. 80-5.

    Article  PubMed  Google Scholar 

  19. Bucher, P., P. Gervaz, and P. Morel, Long-term results of radical resection for locally advanced duodenal adenocarcinoma. Hepatogastroenterology, 2005. 52(66): p. 1727-9.

    PubMed  Google Scholar 

  20. Barnes, G., Jr., et al., Primary adenocarcinoma of the duodenum: management and survival in 67 patients. Ann Surg Oncol, 1994. 1(1): p. 73-8.

    Article  PubMed  Google Scholar 

  21. Dindo, D., N. Demartines, and P.A. Clavien, Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg, 2004. 240(2): p. 205-13.

    Article  PubMed Central  PubMed  Google Scholar 

Download references

Financial support

None

Author information

Authors and Affiliations

  1. Hepatobiliary and Liver Transplant Surgical Unit, St. Vincent’s University Hospital, Elm Park, Dublin 4, Ireland

    D. Dorcaratto, H. M. Heneghan, B. Fiore, F. Awan, D. Maguire, J. Geoghegan, K. Conlon & E. Hoti

Authors
  1. D. Dorcaratto
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. H. M. Heneghan
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. B. Fiore
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. F. Awan
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. D. Maguire
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. J. Geoghegan
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. K. Conlon
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. E. Hoti
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to D. Dorcaratto.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Dorcaratto, D., Heneghan, H.M., Fiore, B. et al. Segmental Duodenal Resection: Indications, Surgical Techniques and Postoperative Outcomes. J Gastrointest Surg 19, 736–742 (2015). https://doi.org/10.1007/s11605-015-2744-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11605-015-2744-0

Keywords

Search

Navigation