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Diagnostic and Therapeutic Endoscopy
Volume 2011 (2011), Article ID 645609, 6 pages
http://dx.doi.org/10.1155/2011/645609
Case Report

Local Resection by Combined Laparoendoscopic Surgery for Duodenal Gastrointestinal Stromal Tumor

1Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, Suita, Osaka 565-087, Japan
2Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, 2-2, E-2, Yamadaoka, Suita, Osaka 565-0871, Japan
3Department of Gastroenterological Surgery, Osaka Police Hospital, Japan
4Kansai-Rosai Hospital, Amagasaki, Japan

Received 24 February 2011; Accepted 7 June 2011

Academic Editor: Isidoro Di Carlo

Copyright © 2011 Motohiko Kato et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Combined laparoendoscopic surgery is a novel surgical method which consists of both endoscopic surgery from inside the gastrointestinal tract and laparoscopic surgery from the outside. We report a case of duodenal GIST, in which combined laparoendoscopic local resection was attempted. The lesion was resected endoscopically using endoscopic submucosal dissection technique under laparoscopic assistance. Laparoscope was used for originating the orientation of the tumor, intra-operative EUS, and monitoring serosal injury from the peritoneal cavity. Postoperative hemorrhage occurred; however, precise orientation of the lesion helped us to manage the patient with minimal invasive reoperation. And thus, the bowel integrity was completely preserved, by avoiding segmental duodenal resection and pancreaticoduodenectomy. This novel, less invasive surgical procedure may become an attractive option for the lesions originating in the anatomically challenging portion of the GI tract for endoscopic or laparoscopic surgery alone.