The feasibility and safety of laparoscopic limited resection for duodenal gastrointestinal stromal tumor: a propensity score-matched analysis.

Background: Duodenal gastrointestinal stromal tumors (GISTs) are rare and pose unique surgical challenges due to their anatomic complexity. However, the feasibility and safety of laparoscopic surgery for duodenal GISTs have not been fully evaluated. This study aimed to compare laparoscopic limited resection (LLR) with open limited resection (OLR) for primary localized duodenal GISTs.

Methods: A retrospective analysis of patients undergoing duodenal GIST resection from January 2015 to April 2025 was conducted. Propensity score matching (PSM) was performed to minimize confounder factors. Outcomes including operative metrics, postoperative recovery, complications, and recurrence were assessed between LLR and OLR. Statistical analyses compared cohorts pre- and post-matching.

Results: A total of 82 patients undergoing limited resection for duodenal GISTs were enrolled, of whom 51 received OLR and 31 received LLR. After 1:1 PSM (n = 58), the two groups were balanced based on age, gender, tumor size, tumor location, and neoadjuvant therapy. The statistical significance of primary outcomes remained consistent between pre- and post-matched cohorts. After PSM, LLR showed reduced intraoperative blood loss (20 vs 50 ml, p = 0.004) and faster oral intake resumption (2 vs 6 days, p = 0.014), with comparable operative time (155 vs 125 min, p = 0.297) and complication rates (24.1% vs 41.4%, p = 0.162). No significant differences were observed between the two groups in the long-term survival outcomes confined by a median follow-up of 28 months.

Conclusion: LLR for duodenal GISTs is a feasible and safe treatment. Compared with OLR, LLR has the advantages of less intraoperative blood loss and shorter time to oral intake, without compromising surgical and oncologic outcomes.