Laparoscopic duodenal diverticulectomy

Abstract

We report a case of successful laparoscopic resection of a diverticulum with gastrointestinal bleeding at the third portion of the duodenum. The patient was a 76-year-old man who suffered from persistent tarry stools. An upper gastrointestinal series and endoscopy revealed a large diverticulum with an ulcer and blood clots located at the lateral wall of the distal third portion of the duodenum. Under general anesthesia, a pneumoperitoneum was created by insufflating the abdominal cavity with CO2. There were dense adhesions caused by a previous open cholecystectomy. Four trocars were inserted into the peritoneal cavity for this procedure. After dissecting and identifying the duodenal diverticulum, we performed a diverticulectomy, using an Endo-GIA linear stapler at the base of the retracted diverticulum. There were no intra- or postoperative complications. The operative time was 180 min. Intraoperative bleeding was minimal. Postoperative duodenogram revealed no deformity or stenosis at the resected area. The patient was discharged after an uneventful course, and he has been doing well with no complaints during the follow-up period.