Pancreas-Sparing Duodenectomy for Duodenal Polyposis

Sarmiento, Juan M.; Thompson, Geoffrey B.; Nagorney, David M.; Donohue, John H.; Farnell, Michael B.

doi:10.1001/archsurg.137.5.557

Cited by 87 publications

(63 citation statements)

References 13 publications

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“…With the recent improvement in knowledge of the anatomy of the pancreatic head, pancreas-sparing total duodenectomy has been successfully performed for duodenal tumors [8][9][10]. This is technically demanding and its application is best limited to highly specialized large volume institutions.…”

Section: Discussionmentioning

confidence: 99%

Gastrointestinal stromal tumor involving the second and third portion of the duodenum: Treatment by partial duodenectomy and Roux‐en‐Y duodenojejunostomy

Goh

Chow

Ong

et al. 2005

Journal of Surgical Oncology

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The optimal surgical procedure for duodenal gastrointestinal tumors (GIST) remains undefined because while surgical resection clearly confers survival advantage, there is little submucosal spread in GIST and lymphatic involvement is rare. Various surgical procedures for duodenal GIST, pancreatoduodenectomy, pancreas-sparing duodenectomy, segmental duodenectomy, or local resection, have been described depending on the size and exact site of the lesion. In this report, we describe two cases of GIST involving the second and third portion of the duodenum successfully treated by partial duodenectomy with Roux-en-Y duodenojejunostomy. This surgical technique is ideal when GIST does not involve the ampulla as it avoids a pancreatoduodenectomy and has not been previously described for the management of this malignancy.

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Section: Discussionmentioning

confidence: 99%

Gastrointestinal stromal tumor involving the second and third portion of the duodenum: Treatment by partial duodenectomy and Roux‐en‐Y duodenojejunostomy

Goh

Chow

Ong

et al. 2005

Journal of Surgical Oncology

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“…More recently, pancreas-sparing duodenectomy has been described for both sporadic and FAP-associated duodenal adenomas. In this procedure the duodenum is dissected away from the head of the pancreas and the ampulla anastomosed to the jejunum 43,44 . Although advocates of this technique emphasize its potential role in FAP, to date there is limited experience and follow-up data are lacking.…”

Section: Discussionmentioning

confidence: 99%

Pylorus-preserving pancreaticoduodenectomy for advanced duodenal disease in familial adenomatous polyposis

Gallagher

Shankar

Groves

et al. 2004

British Journal of Surgery

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“…(7)(8)(9)17,18). In these patients despite the reconstructed duodenum is soon crossed by gastric contents, there is a combined pancreaticobiliary anastomosis, and the whole pancreas is preserved, anastomotic leaks are reported to close spontaneously with controlled drainage (7)(8)(9)17,18 …”

Section: Microscopic Evaluation Revealed a Diffuse Proliferation Of Lmentioning

confidence: 99%

“…Although most of the authors who have reported on total removal of either native (7,(9)(10)(11)17,18) or graft duodenum (12,13) …”

Section: In Constructing Duct-to-mucosa Anastomosis We Have Decided Tmentioning

confidence: 99%

Total Duodenectomy with Enteric Duct Drainage: A Rescue Operation for Duodenal Complications Occurring after Pancreas Transplantation

Boggi¹,

Vistoli²,

Chiaro³

et al. 2010

American Journal of Transplantation

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Duodenal graft complications (DGC) occur frequently after pancreas transplantation but rarely cause graft loss. Graft pancreatectomy, however, may be required when DGC compromise recipient's safety. We herein report on two patients with otherwise untreatable DGC in whom the entire pancreas was salvaged by means of total duodenectomy with enteric drainage of both pancreatic ducts. The first patient developed recurrent episodes of enteric bleeding, requiring hospitalization and blood transfusions, starting 21 months after transplantation. The disease causing hemorrhage could not be defined, despite extensive investigations, but the donor duodenum was eventually identified as the site of bleeding. The second patient was referred to us with a duodenal stump leak, 5 months after transplantation. Two previous surgeries had failed to seal the leak, despite opening a diverting stoma above the duodenal graft. Thirty-nine and 16 months after total duodenectomy with dual duct drainage, respectively, both patients are insulin-independent and free from abdominal complaints. Magnetic resonance pancreatography shows normal ducts both basal and after intravenous injection of secretin. The two cases presented herein show that when DGC jeopardize pancreas function or recipient safety, total duodenectomy with enteric duct drainage may become an option.

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Pancreas-Sparing Duodenectomy for Duodenal Polyposis

Cited by 87 publications

References 13 publications

Gastrointestinal stromal tumor involving the second and third portion of the duodenum: Treatment by partial duodenectomy and Roux‐en‐Y duodenojejunostomy

Gastrointestinal stromal tumor involving the second and third portion of the duodenum: Treatment by partial duodenectomy and Roux‐en‐Y duodenojejunostomy

Pylorus-preserving pancreaticoduodenectomy for advanced duodenal disease in familial adenomatous polyposis

Total Duodenectomy with Enteric Duct Drainage: A Rescue Operation for Duodenal Complications Occurring after Pancreas Transplantation

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