Laparoscopic duodenectomy for benign nonampullary duodenal neoplasms.

BACKGROUND: The aim of this study was to review our experience with laparoscopic duodenectomy for benign duodenal neoplasms and compare with a contemporary cohort of open duodenectomy. METHODS: Twelve cases of laparoscopic duodenectomy for benign duodenal tumors not amenable to endoscopic resection and away from the ampulla performed from 2009 to 2011 at our institution were retrospectively reviewed. Demographic information, patient comorbidities, procedural data, and postoperative outcomes were analyzed. These data were compared with the data derived from 6 patients who underwent open duodenectomy for benign duodenal tumors. RESULTS: Comparison of the laparoscopic to open duodenectomy data demonstrated that the length of stay was similar between the 2 groups (6.1 ± 0.72 vs. 7 ± 2.1, respectively, P>0.05), but the laparoscopic group was associated with a lower combined short-term and long-term complication rate. Statistically significant difference in patients' body mass index (31 ± 10 for the laparoscopic group vs. 22 ± 4 for the open group, P<0.05) was yielded. The remainder of the preoperative, intraoperative, and postoperative variables were similar or not statistically different. The mean follow-up for the laparoscopic group was 12 ± 3 months. There were no recurrences in either group. CONCLUSIONS: Laparoscopic partial duodenal resection is a safe and effective alternative approach to managing patients with benign nonampullary duodenal neoplasms that are not amenable to endoscopic resection and had similar outcomes compared with the traditional open resection with the added benefit of less postoperative incisional hernias, also suited for patients with higher body mass index.

Duke Scholars

Author Theodore N. Pappas Surgery, Minimally Invasive Surgery