title: Local resection by combined laparoendoscopic surgery for duodenal gastrointestinal stromal tumor.
abstract: Combined laparoendoscopic surgery is a novel surgical method which consists of both endoscopic surgery from inside the gastrointestinal tract and laparoscopic surgery from the outside. We report a case of duodenal GIST, in which combined laparoendoscopic local resection was attempted. The lesion was resected endoscopically using endoscopic submucosal dissection technique under laparoscopic assistance. Laparoscope was used for originating the orientation of the tumor, intra-operative EUS, and monitoring serosal injury from the peritoneal cavity. Postoperative hemorrhage occurred; however, precise orientation of the lesion helped us to manage the patient with minimal invasive reoperation. And thus, the bowel integrity was completely preserved, by avoiding segmental duodenal resection and pancreaticoduodenectomy. This novel, less invasive surgical procedure may become an attractive option for the lesions originating in the anatomically challenging portion of the GI tract for endoscopic or laparoscopic surgery alone.
authors.affiliation: Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, Suita, Osaka 565-087, Japan.
authors.forename: Motohiko
authors.initials: M
authors.lastname: Kato
authors.forename: Kiyokazu
authors.initials: K
authors.lastname: Nakajima
authors.forename: Toshirou
authors.initials: T
authors.lastname: Nishida
authors.forename: Makoto
authors.initials: M
authors.lastname: Yamasaki
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Nishida
authors.forename: Shusaku
authors.initials: S
authors.lastname: Tsutsui
authors.forename: Hideharu
authors.initials: H
authors.lastname: Ogiyama
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Yamamoto
authors.forename: Takuya
authors.initials: T
authors.lastname: Yamada
authors.forename: Masaki
authors.initials: M
authors.lastname: Mori
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Doki
authors.forename: Norio
authors.initials: N
authors.lastname: Hayashi