Abstract: Objective:To summarize the surgical skills of the pancreaticoduodenectomy via mesenteric approach for the treatment of duodenal gastrointestinal stromal tumors (GISTs).
Methods:The clinical data of 1 patient with huge duodenal GIST combined with gastrointestinal hemorrhage and liver metastasis who was admitted to the Second Affiliated Hospital of Harbin Medical University in June 2014 were retrospectively analyzed. The patient had continuous bleeding before the operation. The results of computed tomography (CT) showed that there was a solid tumor below the liver and in front of the right kidney, with the size of 12.2 cm×8.1 cm, inferior vena cava was squeezed by the tumor, a solid tumor was detected in the right lobe of liver, and the colon was suspiciously invaded by the tumor. The patient received pancreaticoduodenectomy, right hemicolectomy and right lobectomy of liver metastases. The patient was followed up by out patient examination and telephone interview up to August 2014.
Results:The operation time, volume of blood loss and volume of red blood cell (RBC) transfusion were 420 minutes, 800 mL and 2 U, respectively, with a full recovery of patients. The duodenal GIST with metastasis tumor and necrosis located at the colon, pancreatis, liver and renal hilum was confirmed by pathological diagnosis. The life quality of the patient was good by followup at postoperative month 3.
Conclusion In the pancreaticoduodenectomy via mesenteric approach, surgeons perform vigorously the method of mesenteric approach at the first stage of operation, it could maximally reduce the risk of operation and the volume of blood loss.