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Endoscopy‐assisted laparoscopic submucosal dissection for a duodenal epithelial tumor
Author(s) -
Miyazaki Yasuhiro,
Takiguchi Shuji,
Kurokawa Yukinori,
Takahashi Tsuyoshi,
Fukuda Yasunari,
Yamasaki Makoto,
Makino Tomoki,
Tanaka Koji,
Motoori Masaaki,
Kimura Yutaka,
Nakajima Kiyokazu,
Mori Masaki,
Doki Yuichiro
Publication year - 2019
Publication title -
asian journal of endoscopic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.372
H-Index - 18
eISSN - 1758-5910
pISSN - 1758-5902
DOI - 10.1111/ases.12675
Subject(s) - medicine , duodenum , endoscopy , major duodenal papilla , dissection (medical) , surgery , pancreaticoduodenectomy , laparotomy , endoscopic submucosal dissection , duodenal cancer , laparoscopy , endoscopic mucosal resection , resection
We present the case of a 46‐year‐old obese woman with a 3.5‐cm adenoma in the descending part of the duodenum who was treated with a totally laparoscopic approach. The preoperative examination revealed a pedunculated superficial tumor on the side of pancreas from the inferior duodenal angulus to 5 cm proximal to the papilla that was associated with massive blood flow. We chose not to perform endoscopic submucosal dissection, pancreaticoduodenectomy, or transduodenal tumor excision with laparotomy for this obese patient because of the poor exposure, risk of bleeding, and substantial invasiveness. We performed endoscopy‐assisted laparoscopic submucosal dissection as a novel laparoscopic‐endoscopic cooperative surgical approach in this patient. This surgery was surgically and oncologically safe.