Distal duodenectomy: a new option of surgical treatment for duodenal tumors

Stilidi I.S.; Nered S.N.; Nikulin M.P.; Egenov O.A.; Petrosian A.P.; Arkhiri P.P.

doi:https://doi.org/10.17116/hirurgia20190915

Stilidi I.S.

FGBU "Rossiĭskiĭ onkologicheskiĭ nauchnyĭ tsentr im. N.N. Blokhina" RAMN

ORCID: 0000-0002-0493-1166

Nered S.N.

Rossiĭskiĭ onkologicheskiĭ nauchnyĭ tsentr im. N.N. Blokhina RAMN, Moskva

ORCID: 0000-0002-5403-2396

Nikulin M.P.

Rossiĭskiĭ onkologicheskiĭ nauchnyĭ tsentr im. N.N. Blokhina RAMN, Moskva

Egenov O.A.

Blokhin National Medical Research Centre of oncology of the Health Ministry of the Russia, Moscow, Russia

ORCID: 0000-0002-8681-7905

Petrosian A.P.

Blokhin National Medical Research Centre of oncology of the Health Ministry of the Russia, Moscow, Russia

ORCID: 0000-0002-7663-0362

Arkhiri P.P.

Blokhin National Medical Research Centre of oncology of the Health Ministry of the Russia, Moscow, Russia;
Russian Medical Academy of Continuous Professional Education of the Health Ministry of the Russia, Moscow, Russia

Distal duodenectomy: a new option of surgical treatment for duodenal tumors

Authors:

Stilidi I.S., Nered S.N., Nikulin M.P., Egenov O.A., Petrosian A.P., Arkhiri P.P.

More about the authors

Journal: Pirogov Russian Journal of Surgery. 2019;(9): 5‑12

DOI: 10.17116/hirurgia20190915

Read: 4823 times

To cite this article:

Stilidi IS, Nered SN, Nikulin MP, Egenov OA, Petrosian AP, Arkhiri PP. Distal duodenectomy: a new option of surgical treatment for duodenal tumors. Pirogov Russian Journal of Surgery. 2019;(9):5‑12. (In Russ., In Engl.)
https://doi.org/10.17116/hirurgia20190915

Подписка 2026 Хирургия. Журнал им. Н.И. Пирогова (Pirogov Russian Journal of Surgery)

Использование инфографики авторами научных работ

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Abstract:

Objective — to assess severity, safety and functional advisability of distal pancreatectomy using original surgical technique developed in the Blokhin National Medical Research Centre of Oncology. Material and methods. There were 10 patients with duodenal malignancies who have undergone distal pancreatectomy in the Blokhin National Medical Research Centre of Oncology for the period 2006—2018. Distal pancreatectomy for primary duodenal tumors was performed in 8 patients, 2 patients underwent surgery for external invasion of the duodenum. Results. Postoperative complications Clavien—Dindo grade 1 and 2 occurred in 4 (40%) patients. Surgical complication grade 2 occurred in 1 (10%) patient (pancreatic fistula with effective conservative management). There were no cases of leakage of duodenal stump and duodenojejunostomy, impaired bile flow and stenosis of anastomosis with delayed stomach emptying. Conclusion. Distal duodenectomyis associated with low postoperative morbidity, good functionality and quality of life. This procedure is preferred for non-epithelial and neuroendocrine tumors, as well as with secondary malignant duodenal invasion.

Keywords:

distal duodenectomy

pancreaticoduodenectomy

GIST

non-epithelial duodenal tumors

GIST

neuroendocrine duodenal tumors

non-epithelial duodenal tumors

neuroendocrine duodenal tumors

Authors:

Stilidi I.S.

FGBU "Rossiĭskiĭ onkologicheskiĭ nauchnyĭ tsentr im. N.N. Blokhina" RAMN

ORCID: 0000-0002-0493-1166

Nered S.N.

Rossiĭskiĭ onkologicheskiĭ nauchnyĭ tsentr im. N.N. Blokhina RAMN, Moskva

ORCID: 0000-0002-5403-2396

Nikulin M.P.

Rossiĭskiĭ onkologicheskiĭ nauchnyĭ tsentr im. N.N. Blokhina RAMN, Moskva

Egenov O.A.

Blokhin National Medical Research Centre of oncology of the Health Ministry of the Russia, Moscow, Russia

ORCID: 0000-0002-8681-7905

Petrosian A.P.

Blokhin National Medical Research Centre of oncology of the Health Ministry of the Russia, Moscow, Russia

ORCID: 0000-0002-7663-0362

Arkhiri P.P.

Close metadata

References:

Hatzaras I, Palesty JA, Abir F, Sullivan P, Kozol RA, Dudrick SJ, Longo WE. Small-bowel tumors: epidemiologic and clinical characteristics of 1260 cases from the connecticut tumor registry. Arch Surg. 2007;142(3):229-235. https://doi.org/10.1001/archsurg.142.3.229
Richard MG. Malignant tumors of the small intestine. Surg Clin North Am. 1986;66(4):779-785. https://doi.org/10.1016/s0039-6109(16)43988-5
Bilimoria KY, Bentrem DJ, Wayne JD, Ko CY, Bennett CL, Talamonti MS. Small bowel cancer in the United States: changes in epidemiology, treatment, and survival over the last 20 years. Ann Surg. 2009;249(1):63-71. https://doi.org/10.1097/sla.0b013e31818e4641
Chung JC, Chu CW, Cho GS. Management and outcome of gastrointestinal stromal tumours of the duodenum. J Gastrointest Surg. 2010;14(5):880-883. https://doi.org/10.1007/s11605-010-1170-6
Hoffmann KM, Furukawa M, Jensen RT. Duodenal neuroendocrine tumours: classification, functional syndromes, diagnosis and medical treatment. Best Pract Res Clin Gastroenterol. 2005;19(5):675-697. https://doi.org/10.1016/j.bpg.2005.05.009
Ross RK, Hartnett NM, Bernstein L, Henderson BE. Epidemiology of adenocarcinomas of the small intestine: is bile a small bowel carcinogen? Br J Cancer. 1991;63(1):143-145. https://doi.org/10.1038/bjc.1991.29
Goldner B, Stabile BE. Duodenal adenocarcinoma: why the extreme rarity of duodenal bulb primary tumors? Am Surg. 2014;80:956-959.
Goh BK, Chow PK, Ong HS, Wong WK. J.Gastrointestinal stromal tumour involving the second and third portion of the duodenum: treatment by partial duodenectomy and Roux-en-Y duodenojejunostomy. Surg Oncol. 2005;91(4):273-275. https://doi.org/10.1002/jso.20311
De Oliveira ML, Winter JM, Schafer M. Assessment of complications after pancreatic surgery: a novel grading system applied to 633 patients undergoing pancreaticoduodenectomy. Ann Surg. 2006;244(6):931-939. https://doi.org/10.1097/01.sla.0000246856.03918.9a
Kubyshkin VA., Vishnevskiy VA. Cancer of the pancreas. Moscow: Medpraktika-M, 2003. (In Russ.)
Patyutko YuI, Kudashkin NE, Kotelnikov AG. Various types of pancreatodigestive anastomosis in pancreatoduodenectomy. Annals of surgical Hepatology. 2013;18(3):9-14. (In Russ.)
Solaini L, Jamieson NB, Metcalfe M, Abu Hilal M, Soonawalla Z, Davidson BR, McKay C, Kocher HM. Outcome after surgical resection for duodenal adenocarcinoma in the UK. Br J Surg. 2015;102(6):676-681. https://doi.org/10.1002/bjs.9791
Poultsides GA, Huang LC, Cameron JL, Tuli R, Lan L, Hruban RH, Pawlik TM, Herman JM, Edil BH, Ahuja N. Duodenal adenocarcinoma: clinicopathologic analysis and implications for treatment. Ann Surg Oncol. 2012;19(6)1928-1935. https://doi.org/10.1245/s10434-011-2168-3
Stilidi IS, Arkhiri PP, Nikulin MP. Surgical treatment of patients with primary localized and locally advanced gastrointestinal stromal tumors. Journal of NN Blokhin Russian Cancer Research Center RAMS. 2010;21(1):77-82. (In Russ.)
Connolly EM, Gaffney E, Reynolds JV. Gastrointestinal stromal tumours. Br J Surg. 2003;90(10):1178-1186. https://doi.org/10.1002/bjs.4352
Chung JC, Kim HC, Hur SM. Limited resections for duodenal gastrointestinal stromal tumours and their oncologic outcomes. Surg Today. 2016;46(1):110-116. https://doi.org/10.1007/s00595-015-1163-x
Zhou B, Zhang M, Wu J. Pancreaticoduodenectomy versus local resection in the treatment of gastrointestinal stromal tumours of the duodenum. World Journal of Surgical Oncology. 2013;11(1):196. https://doi.org/10.1186/1477-7819-11-196
Struck A, Howard T, Chiorean EG. Non-ampullary duodenal adenocarcinoma: factors important for relapse and survival. J Surg Oncol. 2009;100(2):144-148. https://doi.org/10.1002/jso.21319
Tocchi A, Mazzoni G, Puma F, Miccini M, Cassini D, Bettelli E, Tagliacozzo S. Adenocarcinoma of the third and fourth portions of the duodenum: results of surgical treatment. Arch Surg. 2003;138(1):80. https://doi.org/10.1001/archsurg.138.1.80
Hu JX, Miao XY, Zhong DW, Dai WD, Liu W, Hu W. Surgical treatment of primary duodenal adenocarcinoma. Hepatogastroenterology. 2006;53:858-862.
Kovanov VV. Operative surgery and topographic anatomy. M.: Meditsine, 2001. (In Russ.)
Ankush Golhar, Vivek Mangla, Siddharth Mehrotra, Shailendra Lalwani, Naimish Mehta. Limited distal duodenal resection: Surgical approach and outcomes. A case series. Ann Med Surg (Lond). 2018;30:36-41. https://doi.org/10.1016/j.amsu.2018.04.005
Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240(2):205-213. https://doi.org/10.1097/01.sla.0000133083.54934.ae
Miettinen M, Lasota J. Gastrointestinal stromal tumors. Review on morphology, molecular pathology, prognosis, and differential diagnosis. Cell Mol Med. 2006;10(4):995-1013.
Dorcaratto D, Heneghan HM, Fiore B. Segmental duodenal resection: indications, surgical techniques and postoperative outcomes. J Gastrointest Surg. 2015;19(4):736-742. https://doi.org/10.1007/s11605-015-2744-0
Liang X, Yu H, Zhu LH, Wang XF, Cai X.J. Gastrointestinal stromal tumours of the duodenum: surgical management and survival results. World Journal of Gastroenterology. 2013;19(36):6000-6010. https://doi.org/10.3748/wjg.v19.i36.6000
Susan C Pitt, Henry A Pitt, Marshall S Baker, Kathleen Christians, John G Touzios, James M Kiely, Sharon M Weber, Stuart D Wilson, Thomas J Howard, Mark S Talamonti, Layton F Rikkers. Small pancreatic and periampullary neuroendocrine tumours: resect or enucleate? J Gastrointest Surg. 2009;13(9):1692-1698. https://doi.org/10.1007/s11605-009-0946-z
Jordan PH. A personal experience with pancreatic and duodenal neuroendocrine tumours. J Am Coll Surg. 1999;189(5):470-482. https://doi.org/10.1016/s1072-7515(99)00162-3
Sohn TA, Lillemoe KD, Cameron JL, Pitt HA, Kaufman HS, Hruban RH, Yeo CJ. Adenocarcinoma of the duodenum: factors influencing long-term survival. J Gastrointest Surg. 1998:2(1):79-87. https://doi.org/10.1016/s1091-255x(98)80107-8
Poultsides GA, Huang LC, Cameron JL, Tuli R, Lan L, Hruban RH, Pawlik TM, Herman JM, Edil BH, Ahuja N. Duodenal adenocarcinoma: clinicopathologic analysis and implications for treatment. Ann Surg Oncol. 2012;19(6):1928-1935. https://doi.org/10.1245/s10434-011-2168-3
Tran TB, Qadan M, Dua MM, Norton JA, Poultsides GA, Visser BC. Prognostic relevance of lymph node ratio and total lymph node count for small bowel adenocarcinoma. Surgery. 2015;158(2):486-493. https://doi.org/10.1016/j.surg.2015.03.048
Cloyd JM, Norton JA, Visser BC, Poultsides GA. Does the extent of resection impact survival for duodenal adenocarcinoma? Analysis of 1,611 cases. Ann Surg Oncol. 2015:22(2):573-580. https://doi.org/10.1245/s10434-014-4020-z