کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
---|---|---|---|---|
9401295 | 1288259 | 2005 | 6 صفحه PDF | دانلود رایگان |
عنوان انگلیسی مقاله ISI
Pancreas-Sparing Duodenectomy Is Effective Management for Familial Adenomatous Polyposis
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کلمات کلیدی
موضوعات مرتبط
علوم پزشکی و سلامت
پزشکی و دندانپزشکی
عمل جراحی
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چکیده انگلیسی
Duodenal adenocarcinoma remains the leading cause of cancer death in familial adenomatous polyposis patients following colectomy. Stratification based on Spigelman's criteria provides a means for determining therapy. Spigelman stage IV patients have been selected for pancreas-sparing duodenectomy. Twenty-one patients underwent resection between 1992 and 2004, with a mean age of 58 ± 11 years. The mean time from colectomy to duodenectomy was 27 ± 13 years. Invasive cancer was found in the distal duodenum in one patient. Operative time averaged 327 ± 61 minutes with a mean blood loss of 503 ± 266 ml. There was no mortality, and eight patients (38%) had 14 complications: six (29%) with delayed gastric emptying, four (19%) with biliary/pancreatic anastomotic leak, one with pancreatitis, and one with wound infection. There were two reoperations: one for delayed gastric emptying and one for an early biliary leak. Mean length of stay was 15 ± 10 days. Two late complications occurred: a stomal ulcer and an intestinal obstruction at 48 and 24 months, respectively. Mean follow-up was 79 months (range, 3-152 months). Two patients developed polyps in the advanced jejunal limb and were endoscopically treated. Pancreas-sparing duodenectomy represents a definitive treatment for advanced duodenal polyposis and can obviate the need for pancreaticoduodenectomy.
ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Journal of Gastrointestinal Surgery - Volume 9, Issue 8, 1 November 2005, Pages 1088-1093
Journal: Journal of Gastrointestinal Surgery - Volume 9, Issue 8, 1 November 2005, Pages 1088-1093
نویسندگان
Richard M.D., R. Matthew M.D., Raphael M.D., Nancy R.N., Andrew M.B.B.S., James M.D., Carol M.D.,