The patient was taken to the operating room for exploration and excision of the lesion. Initial laparoscopic attempt at duodenotomy could not be safely completed and the procedure was converted to open.
The duodenum was Kocherized and the first portion of the duodenum was opened longitudinally between stay sutures 3 cm distal to the pylorus. The mucosa over the lesion was opened and the lesion was easily shelled out.
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