内镜下全层十二指肠胃肠道间质瘤切除术

Q3 Medicine

VideoGIE Pub Date : 2025-04-06 DOI:10.1016/j.vgie.2025.04.001

Jeong Hoon Kim MD, Jade Wang MD, Patrick Magahis BA, Adeyinka Adejumo MD, Mark Hanscom MD, David Carr-Locke MD, Reem Sharaiha MD, Kartik Sampath MD

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引用次数: 0

摘要

背景与目的内镜下切除十二指肠胃肠道间质瘤（gist）的文献有限。我们报告成功的内镜下粘膜夹层和暴露全层切除术（FTR）偶然发现的十二指肠间质瘤在一个无症状的65岁男子。方法病变面积1.4 cm，边界明确，主要位于D2后十二指肠壁粘膜下层及距壶腹远端2cm左右的大乳头水平。行横向粘膜切开术，然后进行粘膜下剥离。大部分切除时使用带保护尖端的IT2刀，以保留病变的包膜层。有条不紊地进行解剖，直到病灶整体切除。内窥镜下缝合用单路缝合缝合FTR缺损。内侧粘膜切除部位的外露部分通过额外的间断缝合得到加强。结果闭锁造影十二指肠造影未见渗漏。患者住院36小时无不良事件发生。最终病理证实了低级别间质瘤的完整切除和保留的囊。结论内镜下粘膜下剥离/暴露FTR是一种有效的、微创的十二指肠胃肠道间质瘤切除术方法。此外，内镜下缝合是切除十二指肠闭合缺陷的可行方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Endoscopic full-thickness resection of a duodenal gastrointestinal stromal tumor

Background and Aim

There is limited literature regarding endoscopic removal of gastrointestinal stromal tumors (GISTs) located in the duodenum. We present successful endoscopic submucosal dissection and exposed full-thickness resection (FTR) of an incidentally discovered duodenal GIST in an asymptomatic 65-year-old man.

Methods

The lesion was 1.4 cm and well-defined, primarily located in the submucosal layer of the posterior D2 duodenal wall and the level of the major papilla around 2 cm distal to the ampulla. Transverse mucosotomy was made followed by submucosal dissection. An IT2 knife with a protected tip was used for the majority of resection to preserve the lesion’s capsular layer. Methodical dissection was performed until the lesion was removed en bloc. Endoscopic suturing closed the FTR defect with a single running suture. An exposed aspect of the medial mucosal resection site was reinforced with an additional interrupted suture.

Results

Postclosure contrast duodenogram was negative for leak. The patient was monitored for 36 hours inpatient without adverse events. Final pathology confirmed complete en bloc resection of a low-grade GIST with a preserved capsule.

Conclusion

Endoscopic submucosal dissection/exposed FTR can be an effective, minimally invasive method of resecting duodenal GISTs. In addition, endoscopic suturing is a viable method of resection defect closure in the duodenum.

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来源期刊

VideoGIE Medicine-Gastroenterology

CiteScore

1.50

自引率

0.00%

发文量

132

审稿时长

105 days

期刊介绍： VideoGIE, an official video journal of the American Society for Gastrointestinal Endoscopy, is an Open Access, online-only journal to serve patients with digestive diseases. VideoGIE publishes original, single-blinded peer-reviewed video case reports and case series of endoscopic procedures used in the study, diagnosis, and treatment of digestive diseases. Videos demonstrate use of endoscopic systems, devices, and techniques; report outcomes of endoscopic interventions; and educate physicians and patients about gastrointestinal endoscopy. VideoGIE serves the educational needs of endoscopists in training as well as advanced endoscopists, endoscopy staff and industry, and patients. VideoGIE brings video commentaries from experts, legends, committees, and leadership of the society. Careful adherence to submission guidelines will avoid unnecessary delays, as incomplete submissions may be returned to the authors before initiation of the peer review process.