Spigelman Stage: Recommended Duodenal Surveillance Frequency Spigelman Total Stage Points Frequency of Surveillance 0 0 Every 4 y I [greater than 4 Every 2-3 y or equal to] II 5-6 Every 1-3 y III 7-8 Every 6-12 y IV 9-12 Expert surveillance every 3-6 mo Surgical evaluation Complete mucosectomy or duodenectomy
or Whipple procedure if duodenal papilla is involved Table 4.
with duodenojejunostomy of gastrointestinal stromal tumor involving the duodenum.
We defined operation methods into four categories: OP1: local excision of tumor; OP2: partial pancreatectomy and partial or local pancreatectomy and duodenectomy
without distal/partial gastrectomy; OP3: Whipple's procedure and extended pancreatoduodenectomy; and OP4: other operation methods.
Four months after the delivery, subpartial pancreatectomy, partial gastrectomy, duodenectomy
, cholecystectomy, and omentectomy (Whipple procedure) were performed at the Department of General Surgery, Hacettepe University.
If the perforated duodenal diverticulum is in the fourth portion of the duodenum, partial duodenectomy
can be performed and reconstruction with end-to-side doudenojejunostomy .
Duodenal adenomatosis, a premalignant condition, may warrant duodenectomy
and pancreatectomy as an attempt to prevent malignant transformation after transplantation .
Adenocarcinoma arising in the duodenum is most frequently treated by pancreatoduodenectomy (36.0%), partial duodenectomy
with gastrectomy (28.0%), or partial duodenectomy
45 F  (9) Present case 45 F Case Complaint Exocrine Cause of number drainage perforation (1) Abdominal pain Enteric Rejection (2) Abdominal pain Bladder Simple ulcer (3) Abdominal pain Bladder Cmv duodenitis (4) Hematuria Bladder Rejection (5) Hematuria Bladder CMV duodenitis (6) Abdominal pain Enteric Internal hernia (7) Melena Enteric Rejection (8) Abdominal pain Enteric Avascular necrosis (9) Abdominal pain Enteric Pressure necrosis Case Interval from Operation number surgery to perforation (1) 27 months Graft duodenectomy
(2) 5 months Direct closure (3) 18 months Graft duodenectomy
(4) 1.5 months Direct closure (5) 2 months Graft pancreatectomy (6) 13 months Graft pancreatectomy (7) 0.5 months Graft pancreatectomy (8) 5 months Direct closure (9) 0.5 months Direct closure
General suggestion for the patients with comorbidities is to choose partial duodenectomy
option if the papilla of Vater is free from invasive disease instead of major surgery [17, 25].
After pancreatico duodenectomy
the pancreatic reconstruction was carried out either by pancreatico jejunostomy (duct to mucosa type, dunken in type) or double layer pancreatico gastrostmy.The fistula rate was recorded after both the procedures using the definition of International Study Group on Pancreatic Fistula.
Reported surgical cases of RH have necessitated associated interventions, including nephrectomy, splenectomy, duodenectomy
, and pancreatectomy.3 Among patients that have undergone partial or radical nephrectomy for renal RH, (10-13) pathologic specimens have revealed almost complete replacement by normal renal parenchyma with hemangioma.