2005 SSAT Annual Meeting
Pancreas-Sparing Duodenectomy Is Effective Management for Familial Adenomatous Polyposis

https://doi.org/10.1016/j.gassur.2005.07.021Get rights and content

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.

Key words

Pancreas-sparing duodenectomy
pancreaticoduodenectomy
familial adenomatous polyposis

Cited by (0)

Presented at the Forty-Sixth Annual Meeting of The Society for Surgery of the Alimentary Tract, Chicago, Illinois, May 14–18, 2005 (oral presentation).

View Abstract