Laparoscopic Resection of Multivisceral GastroIntestinal Stromal Tumor (GIST) with Intratumoral Bleeding

Alan Saber, MD, FACS

Product Details
Product ID: ACS-6063
Year Produced: 2020
Length: 5 min.


Introduction: Gastrointestinal stromal tumors (GISTs) most commonly arise in the stomach. We here in presenting a patient with a large multivisceral GastroIntestinal Stromal Tumor with intratumoral bleeding who was resected laparoscopically with a positive outcome.Presentation: A 58-year-old female known to have GIST. She presented with sever upper abdominal pain for 48 hours. CT scan abdomen and pelvis showed a large mixed cystic and solid mass in the left upper quadrant appears to arise from the stomach, 7 x 8 x 11 cm with evidence of bleeding in the lesion. The patient was transfused and EGD showed a 5x 5 cm ulcerated lesion at the greater curvature of the body of the stomach. The persistent of abdominal pain and dropping of the hematocrit necessitated surgical intervention.Procedure: Initial diagnostic laparoscopy revealed a large gastric tumor adherent to anterior abdominal wall. The tumor found to be ruptured and sealed by soft inflammatory adhesions to abdominal wall. The medial aspect of the tumor was firmly adherent to the left lobe of the liver. Decision was made to resect the lateral segment of the liver that densely adherent to the tumor. . The gastric tumor was resected with vertical gastrectomy using endo GIA 60 blue. The specimen was placed into a plastic bag and retrieved through the umbilical port site, which was extended to a 4 cm length. Postoperative course: The patient tolerated the procedure well and went home on POD# 2.CONCLUSIONS: Laparoscopic resection of large mutlivisceral gastrointestinal stromal tumor is technically safe and feasible.