Gastrointestinal Stromal Tumor of the Small Intestine Near the Ligament of Treitz Treated by Laparoscopic Segmental Resection with Duodenojejunostomy —A Case Report—

Abstract

A 69-year-old woman presented to our hospital due to an abnormality in the upper abdomen during an abdominal ultrasound examination. Abdominal computed tomography showed a well-demarcated and enhanced small bowel mass measuring 2 cm, abutting the duodenojejunal junction, in which a stromal tumor in the upper jejunum was strongly suspected. PET-CT showed no abnormal FDG accumulation. For diagnostic or therapeutic purposes, a portion of the ligament of Treitz was dissected laparoscopically, and segmental resection with retrocolic duodenojejunostomy was performed after securing a safe surgical margin from the tumor grossly. The patient's postoperative course was uneventful, and she was discharged on the 8^th postoperative day. Histopathological examination of the specimen showed a very low-grade gastrointestinal stromal tumor (GIST). In recent years, laparoscopic surgery for resectable small bowel GISTs with minimal invasiveness and with preservation of organ function has become widely accepted. However, there are very few reports addressing such surgical procedures for GISTs near the ligament of Treitz. Many reports of small intestinal tumors and duodenal GISTs near the ligament of Treitz have shown a good prognosis, and this minimally invasive procedure might be a feasible surgical technique.