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

doi:10.1111/j.1477-2574.2011.00292.x

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

^*Corresponding author for this work

Surgery

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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 language	English
Pages (from-to)	342-349
Number of pages	8
Journal	HPB
Volume	13
Issue number	5
DOIs	https://doi.org/10.1111/j.1477-2574.2011.00292.x
Publication status	Published - 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

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10.1111/j.1477-2574.2011.00292.xLicence: Free access - publisher

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@article{e15d07b34d40439d8464a7630d5e87ee,

title = "Pancreaticoduodenectomy for advanced duodenal and ampullary adenomatosis in familial adenomatous polyposis",

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.",

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",

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

year = "2011",

month = may,

doi = "10.1111/j.1477-2574.2011.00292.x",

language = "English",

volume = "13",

pages = "342--349",

journal = "HPB",

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number = "5",

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TY - JOUR

T1 - Pancreaticoduodenectomy for advanced duodenal and ampullary adenomatosis in familial adenomatous polyposis

AU - Skipworth, J.R.

AU - Morkane, C.

AU - Raptis, D.A.

AU - Vyas, S.

AU - Olde Damink, S.

AU - Imber, C.J.

AU - Pereira, S. P.

AU - Malago, M.

AU - West, N.

AU - Phillips, R. K.

AU - Clark, S. K.

AU - Shankar, A.

PY - 2011/5

Y1 - 2011/5

N2 - 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.

AB - 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.

KW - familial adenomatous polyposis

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KW - UPPER GASTROINTESTINAL CANCER

KW - RANDOMIZED CONTROLLED TRIAL

KW - CARCINOMA SEQUENCE

KW - SURGICAL-TREATMENT

KW - DUCTAL ADENOCARCINOMA

KW - SURVIVAL

KW - PANCREATICOGASTROSTOMY

KW - RESECTION

KW - PANCREAS

U2 - 10.1111/j.1477-2574.2011.00292.x

DO - 10.1111/j.1477-2574.2011.00292.x

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SN - 1365-182X

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JO - HPB

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