Surgical management of the duodenal manifestations of familial adenomatous polyposis

Background: Duodenal adenomas develop in patients with familial adenomatous polyposis, incurring a risk of carcinoma. When this risk is high, surgery is indicated. The choice of surgical treatment can be difficult as evidence‐based data are lacking. Methods: This is a systematic review of the litera...

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Bibliographic Details
Published in:British journal of surgery 2011-04, Vol.98 (4), p.480-484
Main Authors: Parc, Y., Mabrut, J.-Y., Shields, C.
Format: Article
Language:English
Subjects:
Adenoma - surgery
Adenomatous Polyposis Coli - surgery
Biological and medical sciences
Duodenal Neoplasms - surgery
Duodenoscopy - methods
Duodenum - surgery
Gastroenterology. Liver. Pancreas. Abdomen
General aspects
Humans
Medical sciences
Neoplasm Recurrence, Local - etiology
Pancreatectomy - methods
Postoperative Complications - etiology
Randomized Controlled Trials as Topic
Risk Factors
Stomach. Duodenum. Small intestine. Colon. Rectum. Anus
Treatment Outcome
Tumors
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Summary:Background: Duodenal adenomas develop in patients with familial adenomatous polyposis, incurring a risk of carcinoma. When this risk is high, surgery is indicated. The choice of surgical treatment can be difficult as evidence‐based data are lacking. Methods: This is a systematic review of the literature on the non‐medical management of duodenal lesions arising in the setting of familial adenomatous polyposis. Studies were identified through searching MEDLINE. Studies published between January 1965 and October 2009 were included. Data regarding number of subjects, complications, length of follow‐up, recurrence rate and outcome were extracted. Results: Transduodenal resection does not differ from an endoscopic approach in terms of recurrence. Ampullectomy has limited application as only papillary lesions are amenable to treatment in this manner. Duodenectomy with pancreas preservation is preferable to pancreaticoduodenectomy unless malignancy is present, or cannot be excluded. Conclusion: Surgery should be reserved for advanced or malignant polyps. Copyright © 2011 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. Guidelines for a rare disease
ISSN:0007-1323
1365-2168
DOI:10.1002/bjs.7374