Department of Digestive and Metabolic Surgery, Jean Verdier Hospital, Paris XIII University-University Hospitals of Paris Seine Saint-Denis, Paris, France (Dr. Carandina). Department of Gastrointestinal Surgery, European School of Laparoscopic Surgery, Saint-Pierre University Hospital, Brussels, Belgium (Drs. Mathonet, Cadière).

ABSTRACT

Background: Brunner’s gland hamartoma (BGH) is a rare, proliferative entity arising from alkaline-secreting glands located mainly in the duodenum. In most cases, BGH develops as a polypoid pedunculated lesion of 1 to 2 cm in diameter, whereas in a few cases, the so-called “giant BGH” can reach 12 cm in size. Removal of BGH is required in symptomatic patients, and treatment options include the endoscopic or surgical approach.

Case Report: We report the case of a 33-year-old woman affected by a symptomatic giant BGH. Laparoscopic local surgery was planned. With the patient under general anesthesia, a laparoscopic Kocher maneuver and a polypectomy via duodenectomy were performed. Then the duodenotomy was closed with a horizontal manual suture. The operative time was 75 minutes and blood loss was 40 mL.

Results: The patient made an uneventful recovery and is well at a one-year follow-up. Pathologic examination results showed a 10 2.5-cm BGH without signs of malignancy or dysplasia.

Conclusion: Laparoscopic transduodenal resection can be considered a safe and feasible procedure for large polyps that are not candidates for endoscopic resection.

Key Words: Brunner’s gland hamartoma, Duodenal polyp, Laparoscopy, Excision.

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