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Usefulness of Laparoscopic Side-to-Side Duodenojejunostomy for Gastrointestinal Stromal Tumors Located at the Duodenojejunal Junction

Abstract

Background

Surgery for gastrointestinal stromal tumor (GIST) at the duodenojejunal junction is a technically challenging and difficult procedure because of the anatomical complexity. When it comes to laparoscopic surgery, it is more challenging than open surgery. This study aimed to introduce our laparoscopic procedure and to evaluate its clinical implication by comparing with open procedures.

Method

Between 2003 and 2013, 19 patients underwent segmental resection for a GIST at the duodenojejunal junction: laparoscopic segmental resection with side-to-side duodenojejunostomy (n = 8) and open surgery (n = 11). Clinicopathological findings, operation details, and postoperative outcomes were compared.

Results

Both groups were comparable in demographics and clinicopathological characteristics. Postoperative hospital stay of the laparoscopic group (6.3 days) was significantly shorter than the open group (15.7 days, P = 0.008) while no significant differences were observed regarding estimated blood loss, operation time, and morbidity. All patients in both groups underwent curative resection without operative mortality. Two patients experienced recurrence after open surgery whereas none of the patients after laparoscopic duodenojejunostomy had recurrence with a median follow-up period of 36 months.

Conclusion

Laparoscopic segmental resection with side-to-side duodenojejunostomy for a GIST at the duodenojejunal junction is a safe, feasible, and effective alternative to open approach, providing benefits of minimally invasive surgery.

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Acknowledgments

This study was supported by a grant from the National R&D Program for Cancer Control, Ministry of Health & Welfare, Republic of Korea (1320270). We acknowledge the assistance of BioScience Writers, LLC (Houston, TX, USA) in copyediting of the manuscript and corrections of English language usage.

Conflicts of Interest

None.

Sources of Financial Support

This work was supported by a grant of the Korea Healthcare technology R&D project, Ministry of Health, Welfare, & Family Affairs, Republic of Korea (1320270).

Author information

Correspondence to Woo Jin Hyung.

Electronic Supplementary Material

Below is the link to the electronic supplementary material.

Laparoscopic resection procedure for a gastrointestinal tumor at the duodenojejunal junction (MPG 38820 kb)

Laparoscopic side-to-side duodenojejunostomy after resection of a gastrointestinal tumor at the duodenojejunal junction. (MPG 38424 kb)

Video 1

Laparoscopic resection procedure for a gastrointestinal tumor at the duodenojejunal junction (MPG 38820 kb)

Video 2

Laparoscopic side-to-side duodenojejunostomy after resection of a gastrointestinal tumor at the duodenojejunal junction. (MPG 38424 kb)

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Cite this article

Tanaka, E., Kim, M., Lim, J.S. et al. Usefulness of Laparoscopic Side-to-Side Duodenojejunostomy for Gastrointestinal Stromal Tumors Located at the Duodenojejunal Junction. J Gastrointest Surg 19, 313–318 (2015) doi:10.1007/s11605-014-2699-6

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Keywords

  • GIST
  • Duodenojejunal junction
  • Laparoscopy
  • Resection