Large duodenal villous adenoma requiring head of the pancreas and pylorus-preserving total duodenectomy.
Villous adenomas of the duodenum (VAD) are infrequent lesions of the gastrointestinal tract but have a high risk of recurrence and malignancy. For these reasons and its specific topographic location, the surgical treatment of VAD is still controversial. Herein we present a case of large VAD located in the second duodenal portion that was successfully treated with a head of the pancreas, pylorus-preserving total duodenectomy (PPTD). PPTD should be an excellent option in patients with large adenomas because it allows preservation of the pancreas, gastrointestinal function is maintained, the possibility of a recurrence and of an invasive carcinoma of the ampulla is eliminated, and finally because it permits an adequate endoscopic follow-up. PPTD should not be used in the presence of malignancy and/or high-grade dysplasia.
Cueto
Jorge
J
Department of Surgery, Angeles de las Lomas Hospital, Mexico City, Mexico. cuetoj@prodigy.net.mx
Benotto
Jenny-Ann
JA
Catalina
Romo
R
Vazquez-Frias
Jose A
JA
D018253:Adenoma, Villous / Q000473:pathology / Q000601:surgery*; D004379:Duodenal Neoplasms / Q000473:pathology / Q000601:surgery*; D004386:Duodenum / Q000601:surgery*; D016099:Endoscopy, Gastrointestinal; D005260:Female; D006801:Humans; D008875:Middle Aged