Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jun 26, 2021; 9(18): 4748-4753
Published online Jun 26, 2021. doi: 10.12998/wjcc.v9.i18.4748
Pancreas-preserving duodenectomy for treatment of a duodenal papillary tumor: A case report
Biao Wu, Shi-Yong Chen, Yuan Li, Yu He, Xin-Xin Wang, Xiao-Jun Yang
Biao Wu, Shi-Yong Chen, Yuan Li, Yu He, Xin-Xin Wang, Xiao-Jun Yang, Department of General Surgery, Gansu Provincial Hospital, Lanzhou 730000, Gansu Province, China
Biao Wu, Shi-Yong Chen, Yuan Li, School of Clinical Medicine, Ningxia Medical University, Yinchuan 750000, Ningxia Hui Autonomous Region, China
Author contributions: Wu B and Chen SY contributed equally to this work and should be considered as co-first authors; all authors substantially contributed to the conception and design of the study as well as acquisition, analysis, and interpretation of the data; all authors drafted the article, made critical revisions related to the intellectual content of the manuscript, and approved the final version of the article to be published.
Supported by The National Natural Science Foundation of China, No. 81660398; and The Hospital Key Program of National Scientific Research Cultivation Plan, No. 19SYPYA-12.
Informed consent statement: The patient provided informed consent for the publication of his case.
Conflict-of-interest statement: All authors have no conflict of interest to report.
CARE Checklist (2016) statement: The authors have read the CARE checklist (2016), and the manuscript was prepared and revised according to the CARE checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xiao-Jun Yang, MD, PhD, Chief Doctor, Professor, Surgeon, Department of General Surgery, Gansu Provincial Hospital, No. 204 Donggang West Road, Chengguan District, Lanzhou 730000, Gansu Province, China. yangxjmd@aliyun.com
Received: November 9, 2020
Peer-review started: November 9, 2020
First decision: December 3, 2020
Revised: December 16, 2020
Accepted: April 23, 2021
Article in press: April 23, 2021
Published online: June 26, 2021
Processing time: 214 Days and 3.1 Hours
Abstract
BACKGROUND

Duodenal papillary tumor is a rare tumor of the digestive tract, accounting for about 0.2% of gastrointestinal tumors and 7% of periampullary tumors. The clinical manifestations of biliary obstruction are most common. Some benign tumors or small malignant tumors are often not easily found because they have no obvious symptoms in the early stage. Surgical resection is the only treatment for duodenal papillary tumors. At present, the methods of operation for duodenal papillary tumors include pancreatoduodenectomy, duodenectomy, ampullectomy, and endoscopic resection.

CASE SUMMARY

A 47-year-old man was admitted to because of a duodenal mass that had been discovered 2 mo previously. Electronic gastroscopy at another hospital revealed a duodenal papillary mass that had been considered to be a high-grade intraepithelial neoplasia. Therefore, we conducted a multidisciplinary group discussion and decided to perform a pancreas-preserving duodenectomy and a R0 resection was successfully performed. After surgery, the patient underwent a follow-up period of 5 yr. No recurrence or metastasis occurred.

CONCLUSION

According to our experience with a duodenal papillary tumor, compared with pancreaticoduodenectomy, the use of pancreas-preserving duodenectomy can preserve pancreatic function, maintain gastrointestinal structure and function, reduce tissue damage and complications, and render the postoperative recovery faster. Pancreas-preserving duodenectomy for treatment of a duodenal papillary tumor is feasible under strict control of surgical indications.

Keywords: Duodenal papillary tumor; Benign tumor; Malignant tumor; Pancreas-preserving duodenectomy; Case report

Core Tip: Duodenal papillary tumor is a rare digestive tract tumor because of its special anatomical location. The clinical manifestations of biliary obstruction are most common. Some benign tumors or small malignant tumors are often not easily found because they have no obvious symptoms in the early stage. Surgical resection is the only treatment for duodenal papillary tumors. With the advancement of surgical technology, reducing trauma and improving the quality of life have attracted more and more attention, and the surgical methods have changed accordingly. This case highlights that, under the condition of strictly controlling the indications of operation, pancreas-preserving duodenectomy for treatment of duodenal papillary tumors is feasible.