Abstract
A 60-year-old man presenting with severe anemia was referred to our hospital. Abdominal CT showed a well-demarcated and enhanced tumor growing in the lumen of the intestine, in the left-side of the superior mesenteric vessels, measuring approximately 5.0 cm in diameter. Upper gastro-intestinal endoscopy revealed a submucosal tumor with mucosal ulceration. Duodenography showed the tumor in the third portion of the duodenum. From these findings, we diagnosed the tumor as a submucosal tumor of the duodenum, and performed totally laparoscopic resection with duodenojejunostomy by functional end-to-end anastomosis. The operative time was 238 minutes and the estimated blood loss was 75 ml. The patient had an uneventful post-operative course and was discharged on the 10th postoperative day. Histological examination revealed that the tumor was GIST with low-grade malignancy originating from the duodenum.
Laparoscopic duodenectomy, considering the site and size of the tumor, should be a treatment option even for GIST located in the duodenum from the aspects of the less invasiveness and cosmetic benefit, if the safety surgical margin is secured and the organ function can be preserved.
