Background : The duodenum is an uncommon origin for GIST. The optimal surgical procedure for duondenal GIST is debated, and various options ranging from limited resection to pancreaticoduodenectomy have been reported. Among them, there were a few reports using the laparoscopic limited resection for duodenal GIST, Reports of complications arising from limited resection are not well known. Herein, we report a case of delayed gastric emptying that occurred after laparoscopic subtotal duodenectomy.

Methods : We present a patient in whom an enhancing nodular lesion measuring approximately 1.7 cm in the third part of the duodenum was incidentally discovered on abdomen Computed Tomography(CT). The endoscopic biopsies revealed GIST. A pancreas-sparing segmentral resection from 3rd to 4th portion of duodenum was underwent using a totally laparoscopic approach.

Results : The final diagnosis of the pathologic report revealed duodenal GIST. During the recovery period, there were no problems until taking liquid diet, but delayed gastric emptying occurred when starting solid food diet. We performed GI decompression using a nasogastric tube for approximately 2 weeks and administered prokinectis to the patient. After the conservative treatment, the patient was able to start a diet and was discharged from the hospital one month after surgery.

Conclusions : We determined that delayed gastric emptying(DGE) probably occurred in the patient due to inadequate anastomosis technique and lack of anchoring at the anastomosis site. During the period of conservative treatment, the DGE was considered to have improved as appropriate adhesion between the anastomosis site and the retroperitoneum occurred.