BACKGROUBD: Benign duodenal neoplasms are rare, and their optimal management remains undefined.
METHODS: We analyzed all cases of benign duodenal neoplams treated during a 10-year period (1/1990 through 1/2000) at Brigham and Women¢s Hospital. Data is expressed as mean ± SD.
RESULTS: Sixty-five patients had benign duodenal neoplasms. Thirty-eight patients had duodenal adenomas, and 27 patients had the following lesions: Brunner¢s gland adenoma (9), inflammatory polyp (10), lipoma (1), leiomyoma (1), hamartoma (2), ectopic pancreatic tissue (1), lymphangioma (1), carcinoid (1), and neurofibroma (1). Of the patients with duodenal adenomas, 13 underwent surgical therapy (pancreaticoduodenectomy (4), pancreas-sparing duodenectomy (6), local tumor excision (3)). Twenty-five patients with duodenal adenomas underwent endoscopic resection. Both surgical and endoscopic groups had similar morbidity and mortality rates (Table 1). Of the patients who had surgery, those treated with pancreaticoduodenectomy had larger lesions (93 ± 55 mm vs 35 ± 15 mm, p <0.05) than those who had procedures of lesser magnitude.
CONCLUSIONS: With appropriate selection of endoscopic and surgical therapy, benign duodenal neoplasms can be treated with minimal morbidity and mortality.
Table 1.
Endoscopy Surgery
n 25 13
Size (mm) 12 ± 6 50 ± 33 *
Morbidity 1 (4%) 1 (7%)
Mortality 0 (0%) 0 (0%)
Morbidity: Bleeding, reoperation, and deep venous thrombosis
* p < 0.05 vs Endoscopy
