Published online Sep 14, 2014. doi: 10.3748/wjg.v20.i34.12341
Revised: April 9, 2014
Accepted: April 21, 2014
Published online: September 14, 2014
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.
Core tip: This report describes a case with bleeding hemangiomas in the third portion of the duodenum and successful treatment using a laparoscopic approach. After performing a laparoscopic Kocher maneuver was performed, 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. This minimally invasive technique may be a valid alternative to open surgery for the treatment of benign duodenal tumors in the third portion.