|
Table 3: Surgical procedures according to the location of the GIST in the duodenum.30 |
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|
Portion |
First |
Second |
Third |
Fourth |
|
Lateral face
GIST < 3 cm |
• Wedge Resection • Segmental resection plus Billroth I/gastro-jejunostomy Roux-en-Y
|
• Wedge resection plus primary closure/duodenojejunostomy, Roux-en-Y |
• Wedge resection plus Roux-en-Y primary closure/duodeno-jejunostomy
|
• Wedge resection • Segmental resection plus primary
|
|
GIST >3 cm |
• Segmental resection/antrectomy plus Roux-en-Y gastrojejunostomy • Whipple |
• Whipple |
• Whipple • Segmental resection plus duodeno-duodenostomy • Resection of the third and fourth portions plus duodenojejunostomy |
• Segmental resection plus primary |
|
Medial face
GIST < 3 cm |
• Wedge resection • Segmental resection plus Billroth I/gastro-jejunostomy Roux-en-Y |
• Whipple |
• Whipple • Resection of the third and fourth portions plus duodenojejunostomy • Segmental resection plus duodeno-duodenostomy |
• Segmental resection plus primary jejunostomy |
|
GIST > 3 cm |
• Whipple |
• Whipple |
• Whipple |
• Whipple • Segmental resection plus primary jejunostomy |