A case of duodenal brunner' s gland adenoma treated with hand-assisted laparoscopic surgery

Brunner腺腫は十二指腸良性腫瘍の中では最も発生頻度が高い.小さなものでは内視鏡的に切除されるが,大きさによっては外科的手術でしか切除できないものもある.しかし良性腫瘍であることを考慮すると,できるだけ侵襲の少ない方法で切除することが望ましい.今回我々はハンドアシスト法腹腔鏡下手術で切除しえた十二指腸Brunner腺腫の1例を経験したので報告する. A 71-year-old woman was admitted to the hospital for investigation of a feeling of abdominal fullness after meals. An upper gastrointestinal endoscopy conducted five years earlier had revealed an asymptomatic duodenal polyp. The duodenal polyp was found to be growing. Because endoscopic polypectomy could not be indicated, the polyp was resected by a hand-assisted laparoscopic surgery. A scopic trocar was inserted through the inferior umbilicus and a forceps trocar was inserted through the inferior xyphoid and left upper abdomen. A longitudinal incision of about 7 cm was made in the right upper abdomen, through which a Lap Disk^<[○!R]> was inserted and opened, allowing a resection of the duodenal polyp. The duodenum was closed by Albert-Lembert suture. The resected duodenal polyp with stalk was about 2 cm in diameter and 3 cm in length. The patient had an uneventful postoperative course without any complications and was discharged 18 days after the surgery. The pathological diagnosis was Bruner's gland adenoma. This operative technique, hand-assisted laparoscopic surgery, is of great value in exciting this type of benign tumor, because it permits small incision with safety and accuracy.

ハンドアシスト法腹腔鏡下手術

Brunner腺腫

Lap Disk<[○!R]>

本文データは山口大学医学会の許諾に基づきCiNiiから複製したものである