PMID: 9548099Apr 21, 1998Paper

Prophylactic pancreaticoduodenectomy for premalignant duodenal polyposis in familial adenomatous polyposis

International Journal of Colorectal Disease
S CauseretJ Vignal

Abstract

The frequency of duodenal adenomas in patients with, familial adenomatous polyposis is high. Duodenal adenoma has malignant potential, and duodenal adenocarcinoma is one of the main causes of death in patients who have had previous proctocolectomy. A conservative approach to the treatment of duodenal adenomas (nonsteroidal anti-inflammatory drugs, endoscopy, polypectomy through duodenotomy) is inefficient and unsafe. When invasive cancer occurs in duodenal adenomas, the result of surgery is poor. We have performed prophylactic pancreaticoduodenal resection (PDR) for nonmalignant severe duodenal polyposis in five patients since 1991. No operative mortality was observed. One patient developed a pancreatic fistula which was successfully managed by medical treatment. The mean follow-up was 35 months. All five patients are still alive and have a good functional outcome. Prophylactic PDR may be indicated in familial adenomatous polyposis when duodenal polyposis is severe. Stages III and IV of Spigelman's classification, periampullary adenoma, age above 40, and family history of duodenal cancer are factors that may lead to the decision to perform prophylactic PDR.

Citations

Sep 22, 2006·Journal of Gastroenterology·Yoshiaki MurakamiTaijiro Sueda
Sep 26, 2006·Familial Cancer·Michelle C GallagherSteffen Bulow
Jul 14, 2001·ANZ Journal of Surgery·R R HutchinsS J Snooks
Apr 5, 2007·Digestive Diseases and Sciences·Massimo PicassoMassimo Conio
Dec 2, 2011·Familial Cancer·Musa DriniFinlay A Macrae
Jun 10, 2011·The British Journal of Surgery·Y ParcUNKNOWN Mallorca Group
Sep 28, 2004·The British Journal of Surgery·M C GallagherR K S Phillips

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