Mesenteric approach in pancreas-preserving partial duodenectomy for a gastrointestinal stromal tumor located in the third portion of the duodenum: A ‍case report

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Owing to the anatomical specificity of duodenal gastrointestinal stromal tumors, various surgical techniques are for removal, ranging from local resection to pancreaticoduodenectomy, depending on the location, size, and nature of the tumor. Considering the invasiveness of the procedure and postoperative quality of life, local resection is the preferred choice if complete tumor resection is feasible. However, resection of the third portion of the duodenum is difficult because it lies between the superior mesenteric artery and the abdominal aorta. The patient was a 65-year-old male. Contrast-enhanced abdominal computed tomography revealed a 10-mm mass in the third portion of the duodenum, which was diagnosed as a duodenal gastrointestinal stromal tumor. The patient underwent pancreas-preserving partial duodenectomy via the mesenteric approach, a technique typically used in pancreaticoduodenectomy for pancreatic cancer. Following this approach, the superior mesenteric artery and vein were separated and the mesentery located anterior to the duodenum was removed. Using this method, bleeding could be controlled and the uncinate processes of the pancreas and duodenum could be accurately divided. Pancreas-preserving partial duodenectomy using the mesenteric approach is beneficial for treating gastrointestinal stromal tumors involving the third portion of the duodenum.