Abstract
The patient, a 61-year-old man who was diagnosed as having a duodenal adenoma during a routine medical examination, was referred to our hospital. Endoscopic examination revealed an elevated lesion measuring 1 cm in diameter located adjacent to the duodenal papilla in the posterior wall of the second portion of the duodenum. Another lesion detected on the anal side of the aforementioned lesion was diagnosed as a Brunner's gland adenoma with no endoscopic evidence of malignancy.
We considered one of two therapeutic options : partial resection of the duodenum or endoscopic submucosal dissection of the adenoma. We selected the former and performed partial resection of the duodenum via laparotomy using intraoperative endoscopy.
During the operation, the endoscopist marked around the tumor and the surgeon confirmed the line by following the endoscopic light from outside the duct. We resected the involved segment of the duodenum and sutured the ends. Histopathology revealed a duodenal adenoma and Brunner's gland hyperplasia.
We report that intraoperative endoscopy could be useful as a minimally invasive and function-preserving tool for surgery of lesions around the duodenal papilla.
