A Case of Gastrointestinal Stromal Tumor of the Duodenal 1st portion.

End‐to‐end anastomosis using a surgical instrument after a segmental resection of the distal duodenum

“…A disadvantage of this procedure is that the anastomosis between the duodenum and the jejunum is difficult to perform because the superior mesenteric vessels overlie the anastomotic site. Uehara et al [2] reported a case with GIST in the fourth portion of the duodenum. In this report, the duodenal stump was closed and side-to-side anastomosis was performed between the descending duodenum and the jejunum because an endto-end anastomosis was too difficult to carry out after a segmental resection of the duodenum.…”

“…When performing surgery for this disease, selecting the most appropriate procedure is very important because of the complex anatomical characteristics of the duodenum including the pancreas, superior mesenteric vessels, portal vein, and extrahepatic biliary system [2][3][4]. While a pancreatoduodenectomy (PD) is unavoidable in cases with direct invasion to the pancreas, no standard surgical procedure has yet been established in cases without direct invasion.…”

“…Although malignant gastrointestinal stromal tumors (GIST) of the duodenum are thought to be rare, the number of reported cases has been increasing owing to advance in diagnostic modalities [1,2]. When performing surgery for this disease, selecting the most appropriate procedure is very important because of the complex anatomical characteristics of the duodenum including the pancreas, superior mesenteric vessels, portal vein, and extrahepatic biliary system [2][3][4].…”