Matthew B Dull, MD1, Irina Bernescu, MD1, Benny Kieff, MD2, Nadav Dujovny, MD, FACS2. 1grand rapids medical education partners, 2Spectrum Health Medical Group
Introduction: Duodenal diverticulum are an infrequently encountered entity which are rarely of clinical significance. These lesions are, however, susceptible to injury during laparoscopic dissection. There is no consensus on best management of these lesions when they are injured.
Methods: We present a video case report of an incidentally discovered duodenal diverticulum that was injured during dissection for a laparoscopic right hemicolectomy for treatment of a transverse colon cancer. This diverticulum was resected laparoscopically with the assistance of endoscopic visualization. The patient recovered from surgery well.
Results: Combining laparoscopic and endoscopic techniques, we were able to resect this lesion without added morbidity to the patient, while still ensuring that the ampulla was not injured and the duodenal lumen was not narrowed. The patient recovered well from her initial surgery. She ultimately developed metastatic disease and was enrolled in hospice.
Conclusion: Incidentally discovered duodenal diverticulum are susceptible to injury during the course of dissection. These can be successfully managed with laparoscopic resection. Care should be taken to adequately define the anatomy before resection and ensure that the duodenal lumen is not narrowed.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 78818
Program Number: V147
Presentation Session: Colorectal Video Session
Presentation Type: Video