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Duodenal gastrointestinal stromal tumors (GISTs): arguments for conservative surgery
Stéphane Bourgouin1, Emmanuel Hornez, Jérôme Guiramand
1APHM Hôpital Nord, Department of Visceral Surgery, Aix-Marseille University, Chemin des Bourrely, Marseille, France. stephane_bourgouin@hotmail.fr
Introduction:
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.
Conclusion:
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.
