Reconstruction of a large duodenal defect created by resection of a duodenal tubulovillous adenoma using a double-tract anastomosis to a retrocolic roux-en-y loop: report of a case.
Adenomas arising in the duodenum are uncommon. The surgical approach to adenoma of the duodenum remains controversial. We herein report the successful closure of a large defect after a partial duodenectomy for an adenoma. A 60-year-old man developed duodenal adenoma. An upper gastrointestinal roentgenographic series and endoscopy revealed a 2.5-cm tumor located adjacent to the duodenal papilla. The tumor was too large to be removed endoscopically, and therefore it was resected en bloc by a partial duodenectomy. Histology confirmed the diagnosis of benign tubulovillous adenoma. The large duodenal defect created by resection of the tumor was closed with double-tract anastomosis to a retrocolic Roux-en-Y loop. Large duodenal defects represent difficult surgical problems. Closure by direct anastomosis to a Roux-en-Y loop side-to-side is thus considered to be the procedure of choice.
Department of Surgery, Wakakusa Dai-ichi Hospital, Higashiosaka, Japan.
Hidetoshi
H
Fujiwara
Mitsuo
M
Yamasaki
Shigehiro
S
Nakamura
Kenji
K
Yasuda
Hiromasa
H
Tomiyoshi
Kazuhiro
K
Teramura
D018253:Adenoma, Villous / Q000601:surgery*; D000713:Anastomosis, Roux-en-Y; D004379:Duodenal Neoplasms / Q000601:surgery*; D004386:Duodenum / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged