Laparoscopic pancreas-preserving total duodenectomy for familial adenomatous polyposis

Surg Laparosc Endosc Percutan Tech. 2011 Dec;21(6):e332-5. doi: 10.1097/SLE.0b013e3182397771.

Abstract

Patients with duodenal polyps associated with familial adenomatous polyposis (FAP) have a considerable risk of developing duodenal carcinoma. Prophylactic resection of the duodenum for Spigelman stage III disease is the treatment of choice to prevent progression to cancer. Pancreaticoduodenectomy and pancreas-preserving total duodenectomy (PPTD) are the techniques that have been described for the surgical treatment of duodenal polyposis. We report the first case of laparoscopic PPTD in a patient with previous total colectomy for FAP and Spigelman stage III duodenal polyposis. A laparoscopic total dissection of the duodenum was carried out and the restoration was achieved performing pancreatico-biliary-jejunostomy and gastrojejunostomy. The postoperative period was uneventful. Laparoscopic PPTD can be performed safely in selected cases for the management of FAP.

Publication types

  • Case Reports

MeSH terms

  • Adenomatous Polyposis Coli / surgery*
  • Duodenal Neoplasms / surgery*
  • Humans
  • Laparoscopy / methods*
  • Male
  • Pancreas*
  • Pancreaticoduodenectomy / methods*
  • Young Adult