Brief Article
Copyright ©2010 Baishideng. All rights reserved.
World J Gastroenterol. Jun 14, 2010; 16(22): 2788-2792
Published online Jun 14, 2010. doi: 10.3748/wjg.v16.i22.2788
Segmental duodenectomy for gastrointestinal stromal tumor of the duodenum
Nicolas Christian Buchs, Pascal Bucher, Pascal Gervaz, Sandrine Ostermann, François Pugin, Philippe Morel
Nicolas Christian Buchs, Pascal Bucher, Pascal Gervaz, Sandrine Ostermann, François Pugin, Philippe Morel, Department of Surgery, University Hospital Geneva, 1211, Geneva, Switzerland
Author contributions: Buchs NC, Bucher P and Gervaz P conceived and designed this study; Ostermann S and Pugin F collected the data; Buchs NC, Bucher P and Morel P analyzed and interpreted the data; Buchs NC, Bucher P and Pugin F wrote the manuscript; Gervaz P, Ostermann S and Morel P revised the manuscript critically for important intellectual content; all authors approved the final version of the article.
Correspondence to: Nicolas Christian Buchs, MD, Department of Surgery, University Hospital Geneva, 24 rue Micheli-du-Crest, 1211, Geneva, Switzerland. nicolas.c.buchs@hcuge.ch
Telephone: +41-22-3723311 Fax: +41-22-3727707
Received: January 7, 2010
Revised: March 4, 2010
Accepted: March 11, 2010
Published online: June 14, 2010
Abstract

AIM: To evaluate the results of segmental duodenectomy (SD) and pancreaticoduodenectomy (PD) for duodenal gastrointestinal stromal tumor (GIST) and help clinicians with surgical management.

METHODS: All patients who underwent surgery for non-metastatic GIST of the duodenum in a single institution since 2000 were prospectively followed up. Seven patients (median age 51 years, range: 41-73 years) were enrolled: five underwent SD and two underwent PD.

RESULTS: All the patients had a complete resection (R0), with no postoperative morbidity and mortality. Among the SD group, GIST was classified as low risk in two patients, intermediate risk in two, and high risk in one, according to the Fletcher scale, (vs two high risk patients in the PD group). With a median follow-up of 41 (18-85) mo, disease-free survival (DFS) rates were 100% after SD and 0% after PD (P < 0.05). The median DFS was 13 mo in the PD group.

CONCLUSION: Whenever associated with clear surgical margins, SD is a reliable and curative option for most duodenal GISTs, and is compatible with long-term DFS.

Keywords: Gastrointestinal stromal tumor, Duodenal neoplasms, Segmental duodenectomy, Pancreaticoduodenectomy