Suguru Yamashita1, Yoshihiro Sakamoto1, Akio Saiura2, Junji Yamamoto3, Tomoo Kosuge4, Taku Aoki1, Yasuhiko Sugawara1, Kiyoshi Hasegawa1, Norihiro Kokudo5. 1. Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan. 2. Department of Gastrointestinal Surgery, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Japan. 3. Department of Surgery, National Defence Medical College, Namiki, Tokorozawa, Japan. 4. Hepatobiliary and Pancreatic Surgery Division, National Cancer Center Hospital, Tokyo, Japan. 5. Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan. Electronic address: KOKUDO-2SU@h.u-tokyo.ac.jp.
Abstract
BACKGROUND: Pancreas-sparing duodenectomy (PSD) is a promising alternative procedure to pancreaticoduodenectomy for the treatment of duodenal tumors with low-grade malignant behavior. METHODS: Between March 2003 and September 2012, PSD was performed in 7 patients with a gastrointestinal stromal tumor (GIST) in the second (n = 5) or third (n = 2) portions of the duodenum. The short- and long-term outcomes of treatment were analyzed in all patients. RESULTS: The median blood loss was 160 mL, and the median operative time was 315 minutes. No pancreatic leakage or perioperative mortality occurred. Surgical margins were negative in all cases. All patients were alive at the median follow-up time of 42 months after PSD. The recurrence-free 5-year survival rate was 53% in all patients. Hepatic metastases developed in 2 of the 5 patients with high- or intermediate-grade risks at the time of diagnosis. Hepatic resection was performed, and imatinib mesylate was administered in the 2 cases. CONCLUSIONS: Good short- and long-term outcomes and surgical curability were observed in patients treated with PSD for duodenal GIST.
BACKGROUND: Pancreas-sparing duodenectomy (PSD) is a promising alternative procedure to pancreaticoduodenectomy for the treatment of duodenal tumors with low-grade malignant behavior. METHODS: Between March 2003 and September 2012, PSD was performed in 7 patients with a gastrointestinal stromal tumor (GIST) in the second (n = 5) or third (n = 2) portions of the duodenum. The short- and long-term outcomes of treatment were analyzed in all patients. RESULTS: The median blood loss was 160 mL, and the median operative time was 315 minutes. No pancreatic leakage or perioperative mortality occurred. Surgical margins were negative in all cases. All patients were alive at the median follow-up time of 42 months after PSD. The recurrence-free 5-year survival rate was 53% in all patients. Hepatic metastases developed in 2 of the 5 patients with high- or intermediate-grade risks at the time of diagnosis. Hepatic resection was performed, and imatinib mesylate was administered in the 2 cases. CONCLUSIONS: Good short- and long-term outcomes and surgical curability were observed in patients treated with PSD for duodenal GIST.
Authors: D Dorcaratto; H M Heneghan; B Fiore; F Awan; D Maguire; J Geoghegan; K Conlon; E Hoti Journal: J Gastrointest Surg Date: 2015-01-17 Impact factor: 3.452
Authors: Ser Yee Lee; Brian K P Goh; Eran Sadot; Rahul Rajeev; Vinod P Balachandran; Mithat Gönen; T Peter Kingham; Peter J Allen; Michael I D'Angelica; William R Jarnagin; Daniel Coit; Wai Keong Wong; Hock Soo Ong; Alexander Y F Chung; Ronald P DeMatteo Journal: Ann Surg Oncol Date: 2016-09-13 Impact factor: 5.344