Laparoscopic resection of a duodenal polyp

Introduction: Duodenal polyps are rare lesions traditionally excised using endoscopic or open techniques. Laparoscopic resection is a useful approach for large lesions or in patients not suitable for laparotomy.

Methods: A 56 year-old morbidly obese female (BMI = 60) with anemia was found to have a 3 cm sessile polyp at the junction of the 2nd and 3rd part of the duodenum. Endoscopic ultrasound demonstrated a mucosal-based lesion. Biopsies were consistent with an adenoma, but the lesion was too large for complete endoscopic excision.

Results: After laparoscopic exposure of the duodenum, the lesion was localized by simultaneous endoscopy. The lesion was completely excised through a longitudinal duodenotomy. The duodenotomy was closed transversely using the Endostitch device. A laparoscopic feeding jejunostomy was placed. The patient resumed oral intake on postoperative day 3 and was discharged home on postoperative day 5.

Conclusion: Laparoscopic resection of duodenal polyps may be safely performed in patients unsuitable for endoscopic excision. This minimally invasive approach is an attractive alternative to open resection, especially in the morbidly obese or other high-risk patients.

Session: Podium Video Presentation

Program Number: V033

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