Mohammad H Abo-Ryia, MD, Hamdy S Abd-Allah, MD, Osama H El-Khadrawy, MD, Gamal I Moussa, MD, Ahmed A El-Shora, MD, Shereif A Saber, MD. Faculty of Medicine Tanta University, Tanta Egypt
Introduction: Malignant tumors of the duodenum are extremely uncommon. This cohort presents two year experience of a tertiary hospital.
Patients and methods: From April 2014 till April 2016 we received 8cases of cancer duodenum at the GIT surgery unit general surgery department, Tanta university hospital. Preoperative work up included upper GI endoscopy and biopsy, CT abdomen (digital angiography in cases with suspected vascular invasion), Tumour markers and assessment of fitness for surgery. Deranged parameters due to repeated vomiting or malnutrition were corrected before surgery. One case received neoadjuvant chemotherapy with impressive tumour regression that enables surgical excision.
Results: Eight patients, 4 males and 4 females with mean age of 53.25 ± 8.3, range from 35 to 62y. The presenting complaints in order of frequency were vomiting in 6 patients (75%), upper abdominal pain in 4 patients (50%), weight loss in 3 patients (37.5%) and jaundice in 2 patients (25%). The tumour was in the second part in 3 cases, in the fourth part in 2 cases, one case in the first, one case in the third and multiple nodules in all parts of the duodenum in one case. The gross pathology was ulcerating mass with stricture in 5 cases, mass in 2 cases and multiple nodules in one case while the microscopic type was adenocarcinoma in 7cases and Neuroendocrine tumor in one case. Four cases were submitted to Whipple operation, three cases were submitted to segmental resection and one case palliative bypass. The tumour was T4 in 6 cases and T3 in one case. Lymph nodes were positive in 4 cases (range 2-4 nodes) and negative in 3 cases. No distant metastasis at the time of surgery. The mean follow up was 10.3±9.2 months and the mortality was one case 12.5%.
Conclusion: Surgical excision is possible and could be curative provided the tumour is resectable in case of primary duodenal malignancy.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 77726
Program Number: P385
Presentation Session: Poster (Non CME)
Presentation Type: Poster
