Pancreaticoduodenectomy for advanced duodenal and ampullary adenomatosis in familial adenomatous polyposis

J.R. Skipworth, C. Morkane, D.A. Raptis, S. Vyas, S. Olde Damink, C.J. Imber, S. P. Pereira, M. Malago, N. West, R. K. Phillips, S. K. Clark, A. Shankar

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background: Patients with familial adenomatous polyposis (FAP) develop duodenal and ampullary polyps that may progress to malignancy via the adenoma-carcinoma sequence. Objective: The aim of this study was to review a large series of FAP patients undergoing pancreaticoduodenectomy for advanced duodenal and ampullary polyposis. Methods: A retrospective case notes review of all FAP patients undergoing pancreaticoduodenectomy for advanced duodenal and ampullary adenomatosis was performed. Results: Between October 1993 and January 2010, 38 FAP patients underwent pancreaticoduodenectomy for advanced duodenal and ampullary polyps. Complications occurred in 29 patients and perioperative mortality in two. Postoperative histology revealed five patients to have preoperatively undetected cancer (R = 0.518, P < 0.001). Conclusions: Pancreaticoduodenectomy in FAP is associated with significant morbidity, but low mortality. All patients under consideration for operative intervention require careful preoperative counselling and optimization.
Original languageEnglish
Pages (from-to)342-349
Number of pages8
JournalHPB
Volume13
Issue number5
DOIs
Publication statusPublished - May 2011

Keywords

  • familial adenomatous polyposis
  • adenomatosis
  • pancreaticduodenectomy
  • PYLORUS-PRESERVING PANCREATICODUODENECTOMY
  • UPPER GASTROINTESTINAL CANCER
  • RANDOMIZED CONTROLLED TRIAL
  • CARCINOMA SEQUENCE
  • SURGICAL-TREATMENT
  • DUCTAL ADENOCARCINOMA
  • SURVIVAL
  • PANCREATICOGASTROSTOMY
  • RESECTION
  • PANCREAS

Cite this

Skipworth, J. R., Morkane, C., Raptis, D. A., Vyas, S., Olde Damink, S., Imber, C. J., Pereira, S. P., Malago, M., West, N., Phillips, R. K., Clark, S. K., & Shankar, A. (2011). Pancreaticoduodenectomy for advanced duodenal and ampullary adenomatosis in familial adenomatous polyposis. HPB, 13(5), 342-349. https://doi.org/10.1111/j.1477-2574.2011.00292.x