Pancreas Sparing Distal Duodenectomy of Third and Fourth
Part Duodenum for Neuroendocrine Tumor (NET):
A Case Report and Review of Literature
Arpornsujaritkun N, MD1, Supsamutchai C, MD2, Mingphruedhi S, MD3, Tannapai P, MD4, Leelaudomlipi S, MD1,
Sriphojanart S, MD1
Affiliation :
1 Division of Vascular and Transplant, Department of Surgery, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
2 Division of Gastrointestinal and General Surgery, Department of Surgery, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok,
Thailand
3 Division of Hepato-Pancreato-Biliary Surgery, Department of Surgery, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
4 Department of Radiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
The authors describe a case of the surgical treatment of duodenal neuroendocrine tumor (d-NET) at third and fourth part
(D3-D4) of duodenum. A woman 42 years old presents us with severe intermittent vomiting for 2 months. Her work-up found a
large duodenal wall mass size 8 cm at D3-D4 of duodenum with displaced pancreatic body. We performed a pancreas sparing distal
duodenectomy (PSDD) with end to side duodenojejunostomy with lymphatic dissection. Post-operative course found mild
pancreatitis with infected intra-abdominal fluid collection. She developed partial gut obstruction 2.5 months after operation but
complete resolution by conservative treatment. PSDD is feasible as an operative option to avoid pancreaticoduodenectomy. This
procedure can make adequate negative margin for d-NET. 1 year follow-up has not found any recurrence.
Keywords : Duodenal neuroendocrine tumor, Third and fourth part duodenum, Pancreas sparing distal duodenectomy
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