十二指肠胃肠间质瘤外科治疗的艰难选择:胰十二指肠切除还是局部切除

Tough choice of surgical treatment for duodenal gastrointestinal stromal tumor:pancreaticoduodenectomy or local resection?

十二指肠胃肠间质瘤(GIST)由于其处于特殊的解剖学部位,它的治疗方式选择一直是外科医生关注的重点。目前为止,原发性十二指肠GIST首选治疗方法还是手术切除,包括局部手术切除和胰十二指肠切除。研究认为,十二指肠GIST预后取决于肿瘤自身病理学因素,与手术方式无明显相关,而靶向药物如伊马替尼的强势介入,让十二指肠GIST拥有更多局部切除的机会。双镜技术及机器人技术的发展将为十二指肠GIST的局部微创治疗开启新的纪元。

The therapeutic choice of duodenal gastrointestinal stromal tumor(GIST)has always been the focus of surgeons because of its special anatomy location.So far,surgery is the preferable treatment for primary duodenal GIST,including pancreaticoduodenectomy(PD)and local resection(LR).Researches reveal that the prognosis of duodenal GIST is determined by the pathologic factors of the tumor itself,and is not significantly associated with the surgical procedure.The intervention with targeted drugs such as imatinib has given the duodenal GIST more opportunities for LR.Meanwhile,the technique development of the laparoscopy combined with endoscopic surgery and robotic surgery ensures the steps of minimally invasive treatment for duodenal GIST into a new era.