Segmental resection of the duodenum including the papilla of Vater for focal cancer in adenoma.
OBJECTIVE
Adenoma of the papilla of Vater is a premalignant lesion frequently associated with focal cancer. This adenoma has been treated by a variety of methods, and a consensus for its standard treatment has not been reached. A method of resection which is safe and reliable is desired.


METHODS
The distal part of duodenum and pancreas were separated. The pancreatic and bile ducts were exposed outside the pancreas and duodenum, respectively, and transected. Segmental resection of the distal part of the duodenum including the papilla of Vater was performed. The jejunum was elevated and anastomosed with the duodenum, bile duct, and pancreatic duct.


RESULTS
The resection was safely performed on two patients with focal cancer in adenoma. Delayed gastric emptying which continued for 2 to 3 weeks, occurred in both patients. Postoperatively, the patients resumed a normal life and weigh the same as before surgery.


CONCLUSIONS
Segmental resection of the duodenum including the papilla of Vater is a safe and effective treatment method for adenoma of the papilla of Vater, a premalignant neoplasm that is frequently associated with cancer.
Ryu
M
M
Division of Surgery, National Cancer Center Hospital East, Chiba, Japan.
Kinoshita
T
T
Konishi
M
M
Kawano
N
N
Arai
Y
Y
Tanizaki
H
H
Cho
M H
MH
D018253:Adenoma, Villous / Q000000981:diagnostic imaging / Q000601:surgery*; D014670:Ampulla of Vater / Q000601:surgery*; D000714:Anastomosis, Surgical / Q000379:methods; D003138:Common Bile Duct Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D004386:Duodenum / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography