Engelsk titel: Pancreas-preserving total duodenectomy in familial adenomatous polyposis
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Författare:
Penninga L
;
Svendsen LB
;
Kirkegaard P
;
Bulow S
Email: luitpenninga@hotmail.com
Språk: Dan
Antal referenser: 20
Dokumenttyp:
Fallbeskrivning
UI-nummer: 04121689
Sammanfattning
Introduction: The majority of patients with familial adenomatous polyposis (FAP) develop adenomas in the duodenum. These adenomas have malignant potential and thus warrant regular surveillance and, in some patients, timely intervention. Until a few years ago, the only treatment for patients with severe duodenal adenomatosis was pancreaticoduodenectomy a.m. Whipple. Recently, pancreas-preserving total duodenectomy (PPTD) has been described as a new treatment option, and in this report we describe our experience with PPTD. Materials and methods: In three patients with FAP, PPTD was performed for severe duodenal adenomatosis, Spigelman stage IV. Two patients underwent PPTD without complications, whereas one patient developed postoperative recurrent pancreatitis and ampullojejunostomy leakage, which was succesfully treated conservatively by drainage. Results: Follow-up endoscopy showed adenomas in the neoduodenum in all three patients. All patients were well at a mean follow-up time of 31 months (range 11-46 months). Discussion: Although PPTD is technically demanding, we conclude that it is an effective procedure in FAP patients with severe duodenal adenomatosis. Long-term surveillance is, however, necessary as adenomas may develop in the neoduodenum.