Asportazione laparoscopica di GIST duodenale

Staudacher, Carlo and Orsenigo, Elena and Di Palo, Saverio and Gazzetta, Paolo (2009) Asportazione laparoscopica di GIST duodenale. Il giornale di chirurgia, 30 (5 Supp). p. 121. ISSN 1971-145X

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Abstract

GIST are the most common mesenchymal tumors arising within the gastrointestinal tract and the treatment of choice of these tumor is surgical resection. The small intestine is the second most common site of GIST, of which approximately 20% are found in the duodenum. Our aim was to describe a minimally invasive technique used for the wedge resection of duodenal GIST located near the pancreatic head, compressing the junction of D2 and D3. Case report: A 27-year- old woman presented with nonspecific upper gastrointestinal system symptoms. The endoscopic ultrasound revealed a submucosal tumor arising from the muscolaris propria, located in the proximal part III of the duodenum, 2 cm distal of the papilla of Vater. A laparoscopic operation under general anaesthesia was undertaken with the patient in supine position with the legs abducted. Therefore, a laparoscopic Kocher maneuver was performed. The retroperitoneum was entered using the harmonic scalpel and the dissection extended beyond the vena cava and the duodenum. The location and the size of the lesion have been confirmed using an intraoperative endoscopic examination. The excision of the lesion was performed by use the harmonic scalpel. Then, the duodenal wall was sutured by use endoscopic stitches. The resected lesion was then placed in a retrieval bag and extracted through the port incision. Operating time was 200 min and blood loss 50 ml. The postoperative course was uneventful and she was discharged well on the 6th postoperative day. Histological findings showed a low grade of malignancy GIST and clear microscopic margins. The minimally invasive technique may be a valid alternative to open surgery in the treatment of duodenal GIST. Laparoscopic wedge resection with primary closure can be performed if the resulting lumen is adequate and the ampulla of Vater can be preserved duodenum, GIST, laparoscopy.

Item Type:	Article
Uncontrolled Keywords:	Duodenum, GIST, laparoscopy
Subjects:	600 Tecnologia - Scienze applicate > 610 Medicina e salute (Classificare qui la tecnologia dei servizi medici) > 617 Rami vari della medicina; Chirurgia
Depositing User:	Nadia Del Gobbo
Date Deposited:	11 Feb 2016 14:32
Last Modified:	11 Feb 2016 14:32
URI:	http://eprints.bice.rm.cnr.it/id/eprint/5906

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