Kanaji Shingo, Nakamura Tetsu, Nishi Masayasu, Yamamoto Masashi, Kanemitu Kiyonori, Yamashiita Kimihiro, Imanishi Tatsuya, Sumi Yasuo, Suzuki Satoshi, Tanaka Kenichi, Kakeji Yoshihiro
Shingo Kanaji, Tetsu Nakamura, Masayasu Nishi, Masashi Yamamoto, Kiyonori Kanemitu, Kimihiro Yamashiita, Tatsuya Imanishi, Yasuo Sumi, Satoshi Suzuki, Kenichi Tanaka, Yoshihiro Kakeji, Department of Gastrointestinal Surgery, Faculty of Medicine, Hyogo 650-0017, Japan.
World J Gastroenterol. 2014 Sep 14;20(34):12341-5. doi: 10.3748/wjg.v20.i34.12341.
Benign duodenal tumors are rare and less common than malignant tumors. Furthermore, vascular lesions of the duodenum, including hemangiomas, are rare causes of gastrointestinal bleeding. This report describes a case with bleeding hemangiomas in the third portion of the duodenum and jejunum and their successful treatment using a laparoscopic approach. There is no report of totally laparoscopic resection for tumor in the third portion of duodenum. After performing a laparoscopic Kocher maneuver, the location of the duodenal hemangioma was confirmed by endoscopic and laparoscopic observation. The lesion was excised using ultrasonic coagulating shears and the defect in the duodenal wall was sutured laparoscopically. The hemangioma of the jejunum was treated extracorporeally through a 3.0 cm umbilical incision. The operating time was 241 min and blood loss was negligible. The postoperative course was uneventful. For benign duodenal tumors in the third portion, if endoscopic resection is not adapted, this less invasive technique may be a standard treatment.
良性十二指肠肿瘤较为罕见,比恶性肿瘤更为少见。此外,十二指肠的血管病变,包括血管瘤,是胃肠道出血的罕见原因。本报告描述了一例十二指肠第三部和空肠出现出血性血管瘤的病例,以及采用腹腔镜方法成功治疗的过程。目前尚无关于十二指肠第三部肿瘤完全腹腔镜切除的报道。在进行腹腔镜科克伦氏操作后,通过内镜和腹腔镜观察确认了十二指肠血管瘤的位置。使用超声凝固剪切除病变,并通过腹腔镜缝合十二指肠壁的缺损。空肠血管瘤通过一个3.0厘米的脐部切口进行体外处理。手术时间为241分钟,出血量可忽略不计。术后过程顺利。对于十二指肠第三部的良性肿瘤,如果不适合内镜切除,这种微创技术可能成为标准治疗方法。