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 UNUSUAL CASE
Year : 2021  |  Volume : 17  |  Issue : 2  |  Page : 249-252

Duodenal neuroendocrine tumours in morbidly obese: Amalgamated strategy to optimise outcome


Department of Surgical Gastroenterology and Minimal Invasive Surgery, Santokba Institute of Digestive Surgical Sciences, Santokba Durlabhji Memorial Hospital and Medical Research Center, Jaipur, Rajasthan, India

Correspondence Address:
Dr. Rajesh Bhojwani
SIDSS Office, 3rd Floor, IPD Block, Santokba Durlabhji Memorial Hospital and Medical Research Institute, Bhawani Singh Road, Jaipur - 302 015, Rajasthan
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jmas.JMAS_77_20

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The association of gastroenteropancreatic neuroendocrine tumours (GEP-NETs) with obesity has been reported and researched on. Rendering of a laparoscopic treatment treating these concurring pathologies in unison has not been described. Two morbidly obese patients with duodenal NETs underwent a resectional procedure, with curative intent, in the form of laparoscopic subtotal gastrectomy with roux-en-y gastrojejunostomy with partial duodenectomy and a laparoscopic one-anastomosis gastric bypass-mini gastric bypass with remnant gastrectomy and partial duodenectomy. Both patients had an uneventful convalescence with acceptable weight loss and no evidence of tumour recurrence on follow-up. The indolent nature of NETs, as compared to the morbidity of obesity provides the rationale for treating this particular cohort of patients with a surgical procedure that would serve to remove the tumour and also provide therapeutic benefit for obesity. With experience in advanced laparoscopic procedures, this can be accomplished safely with acceptable results.






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