Abstract
We describe a patient who underwent laparoscopic local resection of the duodenum for a gastrointestinal stromal tumor (GIST) arising in the upper wall of the ascending portion of the duodenum. The patient was a 46-year-old woman who complained general fatigue. Further evaluation revealed a submucosal tumor measuring 5cm in diameter in the ascending portion of the duodenum. Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) showed proliferations of bundles of spindle-shaped cells. The tumor was positive for c-kit and CD34 and negative for alpha-smooth muscle actin and S-100. A GIST was diagnosed, and laparoscopic surgery was performed. The ascending portion of the duodenum was mobilized, and local resection of all layers of the duodenum, including the tumor, was performed. The intestinal defect was closed with an automatic suturing device. There were no postoperative complications. The patient was discharged on postoperative day 8. On pathological examination, the tumor was diagnosed as a moderate-risk GIST. As of three years and six months after surgery, the patient is alive with no recurrence. Laparoscopic local resection of the duodenum for GIST can be performed safely, however, caution should be paid for indication of surgery.
