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World Journal of Surgery

, Volume 42, Issue 12, pp 4005–4013 | Cite as

Laparoscopic Partial Sleeve Duodenectomy for the Infra-Ampullary Gastrointestinal Stromal Tumors of the Duodenum

  • Sung Hoon Choi
  • Jiae Park
  • Chang Moo KangEmail author
  • Woo Jung Lee
Original Scientific Report with Video
  • 184 Downloads

Abstract

Background

Although organ-preserving operations are regarded as effective strategies for duodenal gastrointestinal stromal tumors (GISTs), laparoscopic partial sleeve duodenectomy (lap PSD) has not been fully evaluated. The aims of this study were to evaluate the effectiveness and technical feasibility of lap PSD.

Study design

Between January 2011 and March 2016, we reviewed 13 patients who underwent laparoscopic approach among 22 patients who underwent PSD. PSD for the infra-ampullary lesions was defined as infra-ampullary duodenal resection including the first portion of the jejunum. After resection, all patients underwent reconstruction via side-to-side duodenojejunostomy.

Results

The total mean operation time was 273 min (range 160–346 min), and estimated mean blood loss was 80 ml (range scanty-200 ml). One patient was converted to open laparotomy because of mesocolonic tumor involvement. The median postoperative hospital stay was 10.5 days (range 4–36 days). There were no postoperative mortalities. Postoperative complications included 2 instances of delayed gastric emptying (DGE), 1 duodenojejunostomy stricture, and 2 intestinal obstructions. No patient was treated with adjuvant therapy. One patient experienced hepatic metastasis 28 months after surgery during a mean follow-up period of 48.6 months.

Conclusion

Lap PSD might be an oncologically effective strategy for duodenal GIST, and the laparoscopic approach is a technically feasible and appealing surgical modality in terms of safety and perioperative results. However, DGE and anastomosis strictures are concerns for postoperative complications, which need to be further investigated.

Notes

Acknowledgements

The authors would like to thank to Dong-Su Jang (Medical Illustrator, Medical Research Support Section, Yonsei University College of Medicine, Seoul, Korea) for his help with the figures.

Compliance with ethical standards

Conflict of interest

All authors declare that they have no conflict of interest or financial ties to disclose.

Supplementary material

268_2018_4707_MOESM1_ESM.wmv (84 mb)
Supplementary material 1 (WMV 86065 kb)

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Copyright information

© Société Internationale de Chirurgie 2018

Authors and Affiliations

  • Sung Hoon Choi
    • 1
  • Jiae Park
    • 2
  • Chang Moo Kang
    • 3
    Email author
  • Woo Jung Lee
    • 3
  1. 1.Division of Hepatobiliary and Pancreas, Department of Surgery, CHA Bundang Medical CenterCHA UniversitySeongnamKorea
  2. 2.Department of SurgeryNational Police HospitalSeoulKorea
  3. 3.Pancreatobiliary Cancer CenterYonsei Cancer Center, Severance HospitalSeoulKorea

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