Laparoscopic Resection of Gastrointestinal Stromal Tumors at the Duodenojejunal Junction

Abstract

Introduction:

Segmental resection of gastrointestinal stromal tumors (GISTs) at the duodenojejunal junction is technically challenging, and most cases are performed through an open technique. However, a laparoscopic approach is safe and feasible with good outcomes.

Materials and Methods:

We present a case of a 69-year-old gentleman with melena. Upper endoscopy and computed tomography revealed a 3 × 4 cm mass consistent with a GIST at the deuodenojejunal junction. The patient desired a laparoscopic resection.

Results:

The patient underwent a laparoscopic segmental resection of the GIST without complication. The ligament of Trietz was divided and the duedenojejunal junction was dissected using an ultrasonic scalpel. The GIST and corresponding bowel segment were resected using a laparoscopic stapler. A Kocher maneuver was then performed, and the proximal jejunum was passed in a retrocolic manner to the third portion of the duodenum. A stapled side-to-side duodenojejunostomy was completed. The patient was discharged home on postoperative day 5.

Conclusions:

Laparoscopic resection of duodenojejunal junction GISTs with a side-to-side duodenojejunostomy should be considered in appropriate patients. A laparoscopic approach may provide a shorter hospital course with improved postoperative outcomes. ^{1 –4}

No competing financial interests exist.

Runtime of video: 6 mins 28 secs

Presented at the American College of Surgeons in October 2015 in Chicago, IL.