Laparoscopic Resection of a Duodenal Mass

Clayton Petro, MD, Yuri W Novitsky, MD. University Hospitals Case Medical Center.

 Introduction:  62M with a history of early satiety, unintentional weight loss and reflux found to have a 3cm sessile polyp in the second portion of the duodenum not involving the ampulla.  Pathology reveals an adenomatous polyp.

Methods:  The plan was for endoscopically guided laparoscopic excision of this polyp and primary closure of the duodenal wall.  Critical elements included endoscopic guidance to assure negative margins followed by transverse closure of the D2 wall.

Results:  The patient did well and had a small contained leak on an upper GI that was asymptomatic.  He was discharged on POD#6 and had no post-operative complciations.  

Conclusions: Endoscopic resection of even moderately sized duodenal polyps is possible with primary closure of the duodenal wall.  

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