title: Duodenal gastrointestinal stromal tumors (GISTs): arguments for conservative surgery.
abstract: BACKGROUND
  Gastrointestinal stromal tumors (GISTs) of the duodenum are rare. We sought to evaluate the postoperative courses and long-term outcomes of conservative surgery (CS) versus pancreaticoduodenectomy (PD) for patients with non-metastatic duodenal GISTs.
  
  
  METHODS
  Seventeen patients underwent surgery for duodenal GISTs between January 2000 and January 2012; 11 patients underwent CS (CS group), and six patients underwent a PD (PD group).
  
  
  RESULTS
  Mortality was similar between the two groups. Patients in the PD group had longer operative times, more tumors located on the pancreatic side of the duodenum, higher rates of post-operative complications including postoperative pancreatic fistulas, and a longer hospital stay, when compared with patients of CS group. All tumors were resected with clear surgical margins (R0 resection). The median disease-free survival times were not different.
  
  
  CONCLUSIONS
  CS was safe and provided similar oncologic outcomes as PD. CS should be the procedure of choice in patients with GIST that does not involve the pancreatic side of the duodenum.
authors.affiliation: APHM Hôpital Nord, Department of Visceral Surgery, Aix-Marseille University, Chemin des Bourrely, Marseille, France. stephane_bourgouin@hotmail.fr
authors.forename: Stéphane
authors.initials: S
authors.lastname: Bourgouin
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Hornez
authors.forename: Jérôme
authors.initials: J
authors.lastname: Guiramand
authors.forename: Louise
authors.initials: L
authors.lastname: Barbier
authors.forename: Jean-Robert
authors.initials: JR
authors.lastname: Delpero
authors.forename: Yves-Patrice
authors.initials: YP
authors.lastname: Le Treut
authors.forename: Vincent
authors.initials: V
authors.lastname: Moutardier
mesh_terms: D000328:Adult; D000368:Aged; D018572:Disease-Free Survival; D004379:Duodenal Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D046152:Gastrointestinal Stromal Tumors / Q000556:secondary / Q000601:surgery*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D061646:Operative Time; D010185:Pancreatic Fistula / Q000209:etiology*; D016577:Pancreaticoduodenectomy / Q000009:adverse effects*; D018579:Patient Selection; D012189:Retrospective Studies