Segmental duodenal resection: indications, surgical techniques and postoperative outcomes

J Gastrointest Surg. 2015 Apr;19(4):736-42. doi: 10.1007/s11605-015-2744-0. Epub 2015 Jan 17.

Abstract

Introduction: Segmental duodenal resections (DR) have been increasingly performed for the treatment of primary duodenal tumours. The aim of the study is to review the indications for, clinical and operative details, and outcomes of patients undergoing elective DR.

Material and methods: We retrospectively reviewed all patients who underwent elective segmental DR for the treatment of primary duodenal tumours, at a single institution between January 2007 and December 2013. Demographic data, clinical presentation, preoperative investigations, operative details, postoperative complications/mortality and histopathological results were recorded.

Results: In the study period, 11 duodenal resections were performed (7 male, median age 61 years). Thirty-six percent of the patients presented with anaemia. Surgical resection included two or more segments in seven patients. The most frequently resected part of the duodenum was segment 3 (n = 7). Median operative time was 191 min and blood loss was 675 ml. End-to-end and end-to-side anastomoses were performed in equal numbers. The pathology of resected specimens included adenocarcinoma (n = 4), gastrointestinal stromal tumour (GIST) (n = 1), adenoma (n = 5) and lymphoma (n = 1). Median hospital stay was 14 days. Overall, 30-day morbidity rate was 82% (78% Clavien 2 or less).

Conclusions: Segmental duodenal resection is a safe and effective surgical technique for the resection of primary duodenal tumours.

MeSH terms

  • Adenocarcinoma / surgery*
  • Adenoma / surgery*
  • Aged
  • Aged, 80 and over
  • Duodenal Neoplasms / pathology
  • Duodenal Neoplasms / surgery*
  • Female
  • Gastrointestinal Stromal Tumors / surgery*
  • Humans
  • Length of Stay
  • Male
  • Middle Aged
  • Patient Selection
  • Retrospective Studies
  • Treatment Outcome