Endolooping Treatment of a Duodenal Gastrointestinal Stromal Tumor: Report of a Case

十二指腸基質瘤並不常見，而發生在瓦特氏乳頭附近極為少見且外科切除可能會有困難。本文報告一位七十歲女性因十二指腸基質瘤之潰瘍併發出血而引起上腹痛及暈厥。因該腫瘤位於瓦特氏乳頭附近，基於手術風險太高，外科切除被迫放棄。我們使用內視鏡以內視鏡用套環結紮並留置腫瘤不予切除的方式，靜待腫瘤缺血後自然脫落繼而解除其引起之腹痛與出血等症狀。追蹤四年多，並未再有腫瘤復發或出血，雖說腫瘤殘留或復發的風險可能存在，但本病例顯示此一相對安全之替代療法或許可以考慮運用在不適合手術切除且低惡性風險之局部性胃腸道基質瘤。

關鍵字

胃腸基質瘤；十二指腸；內視鏡用套環

並列摘要

Duodenal gastrointestinal stromal tumors (GISTs) are uncommon and may be difficult to treat surgically when the tumors involve papilla of Vater. We describe a 70-year-old woman presenting with epigastric pain and syncope due to ulceration and bleeding from a duodenal GIST. Surgical resection of the tumor was abandoned because the tumor was too close to papilla of Vater. We performed an endoloop-and-let-go technique using a standard single-accessory channel endoscope and a detachable endoloop to reduce the tumor size and relieve the patient's symptoms. Follow-up of the patient for 4 years revealed no progression of the tumor or recurrence of bleeding. Although the risks of incomplete tumor reduction and recurrence may exist, this endolooping technique may be considered as a safe alternative treatment for patients with GIST not fit for complete surgical resection.

並列關鍵字

gastrointestinal stromal tumor ； duodenum ； endoloop

國際替代計量

Endolooping Treatment of a Duodenal Gastrointestinal Stromal Tumor: Report of a Case

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