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. 2010 Jun 14;16(22):2788-92.
doi: 10.3748/wjg.v16.i22.2788.

Segmental duodenectomy for gastrointestinal stromal tumor of the duodenum

Nicolas Christian Buchs  1 , Pascal Bucher, Pascal Gervaz, Sandrine Ostermann, François Pugin, Philippe Morel
Affiliations

Segmental duodenectomy for gastrointestinal stromal tumor of the duodenum

Nicolas Christian Buchs et al. World J Gastroenterol. .

Abstract

Aim: To evaluate the results of segmental duodenectomy (SD) and pancreaticoduodenectomy (PD) for duodenal gastrointestinal stromal tumor (GIST) and help clinicians with surgical management.

Methods: All patients who underwent surgery for non-metastatic GIST of the duodenum in a single institution since 2000 were prospectively followed up. Seven patients (median age 51 years, range: 41-73 years) were enrolled: five underwent SD and two underwent PD.

Results: All the patients had a complete resection (R0), with no postoperative morbidity and mortality. Among the SD group, GIST was classified as low risk in two patients, intermediate risk in two, and high risk in one, according to the Fletcher scale, (vs two high risk patients in the PD group). With a median follow-up of 41 (18-85) mo, disease-free survival (DFS) rates were 100% after SD and 0% after PD (P < 0.05). The median DFS was 13 mo in the PD group.

Conclusion: Whenever associated with clear surgical margins, SD is a reliable and curative option for most duodenal GISTs, and is compatible with long-term DFS.

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Figures

Figure 1
Figure 1
Gastrointestinal stromal tumor (GIST) located in the third part of the duodenum with typical computed tomography (CT) appearance. Note the typical CT appearance of GIST with an area of necrosis (central cavitations with surrounding highly vascular tissue) (white arrow: pancreas; black arrow: GIST).
Figure 2
Figure 2
GIST located ion the horizontal duodenum (patient 5, Table 1). Note the close relation between the GIST (short arrow) and the pancreas (long arrow), which was easily dissected during surgery.
Figure 3
Figure 3
Duodeno-jejunal anastomosis. Latero-lateral duodeno-jejunal anastomosis between the second part of the duodenum and the first jejunal loop was easily performed after distal duodenectomy and Kocher maneuver.
See this image and copyright information in PMC

References

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