surgery for gastrointestinal stromal tumors of the duodenum background duodenal gastrointestinal stromal tumors gists represent a unique dilemma with varied surgical treatment options however the impact of operative methods on disease recurrence has never been addressedmethods we retrospectively reviewed the medical records of all patients with duodenal gists treated at our hospital from january 2001 to december 2008results of the 25 patients included for analysis 9 had pancreaticoduodenectomy pd and 16 had limited operation comparison of clinicopathological data between tumors treated by pd and by limited operation showed no significant differences in patient age sex symptoms location of tumor tumor grade immunohistochemical staining pattern or complications after surgery however patients with tumors 5 cm p 0005 or not diagnosed as gists before surgery p 0004 were significantly more frequently treated by pd in multivariable analysis the only significant predictor for disease recurrence was highrisk duodenal gistsconclusions based on the fact that type of operation was not correlated to operative risk and disease recurrence limited operation rather than pd should be attempted for duodenal gist without involvement of papilla of vater to preserve more pancreas parenchyma duodenum and common bile duct