Pancreas-preserving duodenectomy for treatment of a duodenal papillary tumor: A case report

Abstract

BACKGROUND Duodenal papillary tumor is a rare tumor of the digestive tract, accounting for about 0.2% of gastrointestinal tumors and 7% of periampullary tumors. The clinical manifestations of biliary obstruction are most common. Some benign tumors or small malignant tumors are often not easily found because they have no obvious symptoms in the early stage. Surgical resection is the only treatment for duodenal papillary tumors. At present, the methods of operation for duodenal papillary tumors include pancreatoduodenectomy, duodenectomy, ampullectomy, and endoscopic resection. CASE SUMMARY A 47-year-old man was admitted to because of a duodenal mass that had been discovered 2 mo previously. Electronic gastroscopy at another hospital revealed a duodenal papillary mass that had been considered to be a high-grade intraepithelial neoplasia. Therefore, we conducted a multidisciplinary group discussion and decided to perform a pancreas-preserving duodenectomy and a R0 resection was successfully performed. After surgery, the patient underwent a follow-up period of 5 yr. No recurrence or metastasis occurred. CONCLUSION According to our experience with a duodenal papillary tumor, compared with pancreaticoduodenectomy, the use of pancreas-preserving duodenectomy can preserve pancreatic function, maintain gastrointestinal structure and function, reduce tissue damage and complications, and render the postoperative recovery faster. Pancreas-preserving duodenectomy for treatment of a duodenal papillary tumor is feasible under strict control of surgical indications.

An ampullary adenoma presenting with jaundice caused by duodenal intussusception: a case report

“…Currently, the treatment options for duodenal papillary tumors include endoscopic resection and surgical procedures including PD, pancreas-preserving duodenectomy, and ampullectomy [ 3 ]. Regarding the endoscopic treatment of ampullary adenomas, the false-negative rate of endoscopic cancer biopsy has been reported to be 20–30% [ 12 , 13 ].…”

“…Duodenal intussusception secondary to an ampullary adenoma rarely occurs because of the fixed position of the duodenum in the retroperitoneum. Current treatment options for ampullary tumors include endoscopic resection and surgical procedures including pancreaticoduodenectomy (PD), pancreas-preserving duodenectomy, and ampullectomy [ 3 ]. The accuracy of biopsy is relatively low, and in some cases, resected tumors diagnosed as papillary adenoma preoperatively are ultimately diagnosed as carcinoma of the adenoma or adenocarcinoma.…”