Back to Search
Start Over
Pancreas-Sparing Duodenectomy Is Effective Management for Familial Adenomatous Polyposis
- Source :
-
Journal of Gastrointestinal Surgery . Nov2005, Vol. 9 Issue 8, p1088-1093. 6p. - Publication Year :
- 2005
-
Abstract
- Duodenal adenocarcinoma remains the leading cause of cancer death in familial adenomatous polyposis patients following colectomy. Stratification based on Spigelman''s criteria provides a means for determining therapy. Spigelman stage IV patients have been selected for pancreas-sparing duodenectomy. Twenty-one patients underwent resection between 1992 and 2004, with a mean age of 58 ± 11 years. The mean time from colectomy to duodenectomy was 27 ± 13 years. Invasive cancer was found in the distal duodenum in one patient. Operative time averaged 327 ± 61 minutes with a mean blood loss of 503 ± 266 ml. There was no mortality, and eight patients (38%) had 14 complications: six (29%) with delayed gastric emptying, four (19%) with biliary/pancreatic anastomotic leak, one with pancreatitis, and one with wound infection. There were two reoperations: one for delayed gastric emptying and one for an early biliary leak. Mean length of stay was 15 ± 10 days. Two late complications occurred: a stomal ulcer and an intestinal obstruction at 48 and 24 months, respectively. Mean follow-up was 79 months (range, 3–152 months). Two patients developed polyps in the advanced jejunal limb and were endoscopically treated. Pancreas-sparing duodenectomy represents a definitive treatment for advanced duodenal polyposis and can obviate the need for pancreaticoduodenectomy. [Copyright &y& Elsevier]
Details
- Language :
- English
- ISSN :
- 1091255X
- Volume :
- 9
- Issue :
- 8
- Database :
- Academic Search Index
- Journal :
- Journal of Gastrointestinal Surgery
- Publication Type :
- Academic Journal
- Accession number :
- 18984104
- Full Text :
- https://doi.org/10.1016/j.gassur.2005.07.021