title: Laparoscopic pancreas-preserving total duodenectomy for familial adenomatous polyposis.
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.
authors.affiliation: Department of Surgery, North Manchester General Hospital, University of Manchester, Manchester, UK.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Benetatos
authors.forename: Mohannad B
authors.initials: MB
authors.lastname: Ammori
authors.forename: Basil J
authors.initials: BJ
authors.lastname: Ammori
mesh_terms: D011125:Adenomatous Polyposis Coli / Q000601:surgery*; D004379:Duodenal Neoplasms / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D010179:Pancreas; D016577:Pancreaticoduodenectomy / Q000379:methods*; D055815:Young Adult