Severe Duodenal Involvement in Familial Adenomatous Polyposis Treated by Pylorus-Preserving Pancreaticoduodenectomy View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2012-09

AUTHORS

Frédéric Caillié, François Paye, Benoit Desaint, Malika Bennis, Jérémie H. Lefèvre, Yann Parc, Magali Svrcek, Pierre Balladur, Emmanuel Tiret

ABSTRACT

PURPOSE: Pancreaticoduodenectomy is an alternative to pancreas-sparing duodenectomy for radical treatment of duodenal lesions. The aims of this study were to assess the results of pylorus-preserving pancreaticoduodenectomy (PPPD) for severe duodenal polyposis in familial adenomatous polyposis in terms of morbidity, long-term influence on functional results, the recurrence rate of cancer or jejunal polyps, and survival. METHODS: All patients operated on for a PPPD between 1992 and 2009 were included. Clinical data, endoscopic findings, and pathologic examinations were evaluated. RESULTS: A total of 19 patients underwent PPPD for severe duodenal polyposis (17 Spigelman IV, 1 Spigelman III, and 1 invasive carcinoma). Postoperative mortality was nil. The postoperative morbidity rate was 42%, including 4 pancreatic fistulae (21%) and 2 delayed gastric emptying (11%). Pathologic examination found 7 invasive carcinomas, of which only 1 was known before resection. One third of patients operated on without a preoperative diagnosis of malignancy already had an invasive duodenal carcinoma. After a mean follow-up of 58 months, 16 patients were alive. Thirteen patients underwent endoscopic follow-up, and new adenomas were found in 4 (31%). All were treated successfully during the same endoscopic procedure. PPPD did not modify the functional result after coloproctectomy. CONCLUSIONS: PPPD remains a safe and efficient therapeutic option for severe duodenal polyposis in familial adenomatous polyposis patients. More... »

PAGES

2924-2931

Identifiers

URI

http://scigraph.springernature.com/pub.10.1245/s10434-012-2221-x

DOI

http://dx.doi.org/10.1245/s10434-012-2221-x

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1012879595

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/22311120


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