Toyonaga T, Nakamura K, Araki Y, Shimura H, Tanaka M
First Department of Surgery, Kyushu University Faculty of Medicine, Fukuoka, Japan.
Surg Endosc. 1998 Aug;12(8):1085-7. doi: 10.1007/s004649900786.
A 46-year-old man with epigastralgia and slight elevation of urinary 5-hydroxyindole acetic acid (5HIAA) was found to have a well-demarcated carcinoid tumor in the duodenal bulb. The tumor measured 8 mm in size, and showed submucosal involvement but no metastasis to the liver and regional lymph nodes. After laparoscopic exposure and lifting of the duodenal wall around the tumor, wedge resection of the duodenal bulb including the tumor was performed successfully with a laparoscopic endostapler under direct endoscopic control. The postoperative course of the patient was uneventful. Laparoscopic wedge resection of the duodenum would be an appropriate minimally invasive treatment of selected duodenal neoplasms with special preoperative assessments and intraoperative considerations.
一名46岁男性,有上腹部疼痛,尿5-羟吲哚乙酸(5HIAA)轻度升高,被发现十二指肠球部有一个边界清晰的类癌肿瘤。肿瘤大小为8毫米,显示有黏膜下浸润,但无肝及区域淋巴结转移。在腹腔镜暴露并提起肿瘤周围的十二指肠壁后,在直接内镜控制下,使用腹腔镜腔内吻合器成功地对包括肿瘤在内的十二指肠球部进行了楔形切除。患者术后恢复顺利。对于经过特殊术前评估和术中考虑的特定十二指肠肿瘤,腹腔镜十二指肠楔形切除术是一种合适的微创治疗方法。