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  • Title: [Minilaparotomy in Pancreas-Preserving Total Duodenectomy for Familial Adenomatous Polyposis Associated with Spigelman Stage Ⅳ Duodenal Polyposis].
    Author: Watanabe Y, Baba H, Sobajima J, Fukuchi M, Kumagai Y, Ishibashi K, Mochiki E, Ishikawa H, Ishida H.
    Journal: Gan To Kagaku Ryoho; 2015 Nov; 42(12):1761-3. PubMed ID: 26805164.
    Abstract:
    INTRODUCTION: Reports on pancreas-preserving total duodenectomy (PPTD) for duodenal polyposis (DP) in familial adenomatous polyposis (FAP) patients are rare. We herein report a case of PPTD performed by minilaparotomy for DP in an FAP patient. CASE: A 27-year-old female FAP patient was diagnosed with Spigelman classification (SC) stage Ⅳ DP on gastroduodenoscopy. She underwent PPTD through a 7 cm upper abdominal incision. All polyps were confirmed as adenomas histopathologically. After 6 months of follow-up, complications related to total duodenectomy, such as weight loss, diabetes mellitus, and fatty liver have not been observed. DISCUSSION: SC stage Ⅳ refers to non-advanced cancers, and PPTD is basically prophylactic surgery. Therefore, pancreatoduodenectomy seems too aggressive for SC stage Ⅳ patients. PPTD by minilaparotomy is suitable for young female patients for its curability, esthetic outcome, and safety.
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