Complete wedge resection for duodenal gastrointestinal stromal tumour: A case series of three patients. (January 2022)

• Record Type: Journal Article
• Authors: Ito, Tomoaki; Kushida, Tomoyuki; Sakurada, Mutsumi; Tanaka, Kenichiro; Sato, Koichi; Maekawa, Hiroshi
• Is Part Of: International journal of surgery case reports. Volume 90(2022)
• Publication Date: 2022-01
• Subjects: CT computed tomography -- EUS endoscopic ultrasonography -- GIST gastrointestinal stromal tumour -- HPF high power field -- IVC inferior vena cava -- LECS laparoscopy endoscopy cooperative surgery -- SMT submucosal tumour; Gastrointestinal stromal tumour -- Gastrointestinal stromal tumours -- Duodenum -- Wedge resection -- Case series; Surgery -- Periodicals; Surgical Procedures, Operative -- Periodicals; Surgery; Electronic journals; Periodicals; 617.005
• DOI: 10.1016/j.ijscr.2021.106674
• Languages: English
• ISSNs: 2210-2612

Abstract

Abstract: Introduction: Duodenal gastrointestinal stromal tumours (GIST) are rare. Therefore, difficulties are experienced when selecting the appropriate surgical procedure in patients with duodenal GISTs. This report presents the cases of three patients with duodenal GISTs who underwent wedge resection. This report would help surgeons identify clinical features and surgical procedures in patients with duodenal GISTs. Presentation of case: Three patients were diagnosed with duodenal submucosal tumours. The first patient presented with melena, the second with postoperative anaemia, and the third with an incidental finding of a large abdominal tumour after presenting with ischaemic colitis. All tumours arose in the 2nd portion of the duodenum and measured 3.5, 3, and 9.2 cm, respectively. Wedge resection of the duodenum was performed in all patients. In patients one and two, simple closure of duodenal wall was performed after wedge resection. In patient three, side-to-side anastomosis with the jejunum was performed because a large area of the wall was removed using the wedge resection technique. Pancreatoduodenectomy was avoided in all patients. Recurrence was not noted in any patient. Discussion: Since GISTs are not generally associated with lymph node metastasis, local resection with negative margins is sufficient to surgically manage patients with GISTs. Conclusion: Our results indicated the effectiveness of performing wedge resection for duodenal GISTs not in close proximity to the ampulla of Vater. Moreover, less invasive procedures should be adopted in patients with duodenal GISTs. Highlights: GIST are derived from the intestinal cells of Cajal in the GIT and mesentery. The occurrence of duodenal GIST is rare. Complete wedge resection was performed for GIST at the 2nd portion of the duodenum. Wedge resection is a feasible and safe surgical method for duodenal GISTs.