Evolution of Surgical Resection for Duodenal Duplication Cyst

Kevin L. Anderson, Jr, BS, Kristy L. Rialon, MD, Theodore N. Pappas, MD, Alexander Perez, MD

School of Medicine (Mr Anderson) and Department of Surgery (Drs Pappas and Perez), Duke University Medical Center, Duke University, Durham, North Carolina, USA.
Department of General and Thoracic Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada (Dr. Rialon).

ABSTRACT

Introduction: Duodenal duplication cysts are rare congenital malformations that are most often identified incidentally and managed nonoperatively. Because of the location of the cyst, it can obstruct the biliopancreatic ampulla requiring operative intervention. An open surgical approach is the conventional procedure for these patients.

Case Descriptions: Since 1990, our institution has resected 3 duodenal duplication cysts. Symptomatic 15- and 17-year-olds underwent open resection of duplication cysts. Most recently, a 25-year-old woman presented with recurring pancreatitis and was subsequently diagnosed with a duodenal cyst on computed tomographic scan and endoscopic ultrasonography. The patient was taken to the operating room for laparoscopic excision. Operative time for the laparoscopic approach was 2 hours and 45 minutes, with no significant intraoperative blood loss. Postoperative recovery was uneventful in all cases.

Discussion: After identification of appropriate operative candidates, laparoscopic resection for duodenal duplication cysts is a feasible procedure that provides smaller incisions and decreased blood loss.

Key Words: Duodenal duplication cyst, Laparoscopic resection, Laparoscopy, Surgical treatment.

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