[Laparoscopic and Endoscopic Cooporative Surgery(LECS)for Superficial Non-Ampullary Duodenal Tumor - A Case Report].

INTRODUCTION

We report a case ofsuperf icial non-ampullary duodenal tumor(SNADT)resected by laparoscopic and endoscopic cooperative surgery(LECS)technique.

CASE PRESENTATION: A 55-year-old man underwent screening esophagogastroduodenoscopy. Endoscopy revealed 0- II a+ II c mucosal lesion measuring 15mm in size located the portion ofduodenum contralateral to the ampulla ofVater. During observation, irregularity in depressed mucosa was observed and malignant alteration was suspected. So, we performed local resection with LECS as diagnostic therapy. During operation, endoscopic mucosal resection(ESD)was performed first. Next, duodenum was mobilized laparoscopically and the floor of the ulcer was closed with endoscopy guided laparoscopic suturing technique. Histopathology revealed tubular adenoma and the resection margin was negative.

DISCUSSION: SNADT is rare condition and therapeutic strategy for SNADT has not established. Further study are needed.