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Case Reports
. 2013 Oct 21;19(39):6693-8.
doi: 10.3748/wjg.v19.i39.6693.

Laparoscopic transduodenal local resection of periampullary neuroendocrine tumor: a case report

Ren-Chao Zhang  1 , Xiao-Wu Xu, Di Wu, Yu-Cheng Zhou, Harsha Ajoodhea, Ke Chen, Yi-Ping Mou
Affiliations
Case Reports

Laparoscopic transduodenal local resection of periampullary neuroendocrine tumor: a case report

Ren-Chao Zhang et al. World J Gastroenterol. .

Abstract

Studies on laparoscopic transduodenal local resection have not been readily available. Only three cases have been reported in the English-language literature. We describe herein a case of 25-year-old woman with periampullary neuroendocrine tumor (NET). Endoscopic ultrasonography revealed a duodenal papilla mass originated from the submucosa and close to the ampulla. The periampullary tumor was successfully managed with laparoscopic transduodenal local resection without any procedure-related complications. Pathological examination showed a NET (Grade 2) with negative margin. The patient was followed up for six months without signs of recurrence. This case suggests that laparoscopic transduodenal local resection is a feasible procedure in selected patients with periampullary tumor.

Keywords: Laparoscopic surgery; Neuroendocrine tumor; Periampullary tumor; Transduodenal local resection.

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Figures

Figure 1
Figure 1
Periampullary tumor (arrow) was detected by gastroscope, endoscopic ultrasonography, and computed tomography. A: Gastroscope; B: Endoscopic ultrasonography; C, D: Computed tomography.
Figure 2
Figure 2
Location of trocars placement.
Figure 3
Figure 3
Steps of the surgical procedures. A: Inserting a cholangiogram catheter through the cystic duct to the duodenum; B: Mobilizing duodenum by the Kocher maneuver; C: Making a longitudinal incision of duodenal wall on the opposite site of the duodenal papilla; D: Performing the resection circumferentially at a distance of 5 mm from the tumor (arrow); E: Identifying pancreaticobiliary duct (arrow) by the cholangiogram catheter; F: Suturing the pancreaticobiliary duct to the surrounding duodenal mucosa; G: After closure of the duodenotomy. IVC: Indicates inferior vena cava; D: Duodenum.
Figure 4
Figure 4
Resected specimen of periampullary neuroendocrine tumor (arrow).
See this image and copyright information in PMC

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