Τίτλος:
Non-whipple operations in the management of benign, premalignant and early cancerous duodenal lesions
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Aim: We reviewed our 20-year experience with non-Whipple operations (pancreas-preserving duodenectomy and transduodenal ampullectomy) for the treatment of benign, premalignant or early-stage malignant duodenal lesions. Patients and Methods: Twenty-four patients who underwent non-Whipple operations between January 1996 and December 2015 were identified from an institutional database and retrospectively analyzed. Results: Between 1996 and 2015, 10 patients underwent pancreas-preserving duodenectomy and 14 patients underwent transduodenal ampullectomy. The mean follow-up was 25.8 months (range=6-54 months) and no patient was lost to follow-up. Eighteen patients had preoperative diagnosis of duodenal adenomatosis, three patients had preoperative diagnosis of duodenal adenocarcinoma, one had a bleeding polyp and two had localized inflammation. Average operative time was 145 min (range=127-168 min) for transduodenal ampullectomy and 183 min (range=173-200 min) for pancreas-preserving duodenectomy (p<0.05). The estimated blood loss for transduodenal ampullectomy was 85 vs. 125 ml for pancreas-preserving duodenectomy (p<0.05). Early postoperative complications were noted in 13 cases (54.17%). There were no postoperative (90-day) deaths observed in this series and there were no recurrences during follow-up for the patients operated on with neoplastic lesions. Conclusion: For carefully selected patients, transduodenal ampullectomy and pancreas-preserving duodenectomy may be used in place of the Whipple operation for benign and occasionally early-stage malignant (Tis and T1) duodenal and ampullary disease.
Συγγραφείς:
Papalampros, A.
Moris, D.
Petrou, A.
Dimitrokallis, N.
Karavokyros, I.
Schizas, D.
Delladetsima, I.
Pappas, T.N.
Felekouras, E.
Περιοδικό:
ANTICANCER RESEARCH
Εκδότης:
International Institute of Anticancer Research
Λέξεις-κλειδιά:
adenomatosis; adult; aged; benign neoplasm; clinical article; clinical outcome; controlled study; data base; duodenal adenocarcinoma; duodenal adenoma; duodenal adenomatosis; duodenal dysplasia; duodenum cancer; duodenum carcinoma; duodenum polyp; duodenum stenosis; early cancer; enteritis; Fogarty catheter; follow up; gastrectomy Billroth II; gastrointestinal stapler; gastrointestinal stromal tumor; histopathology; human; human tissue; intermethod comparison; intestine surgery; middle aged; operation duration; pancreas preserving duodenectomy; partial duodenectomy; patient selection; polydioxanone suture; polyglactin suture; polypropylene suture; postoperative complication; precancer; preoperative period; priority journal; retrospective study; Review; surgical technique; transduodenal ampullectomy; very elderly; vessel sealing system; villous adenoma; algorithm; ampulla of Vater; anastomosis; decision making; Duodenal Neoplasms; female; inflammation; male; pathology; postoperative complication; procedures; surgical oncology; treatment outcome; tumor recurrence, Adult; Aged; Aged, 80 and over; Algorithms; Ampulla of Vater; Anastomosis, Surgical; Decision Making; Duodenal Neoplasms; Female; Follow-Up Studies; Humans; Inflammation; Male; Middle Aged; Neoplasm Recurrence, Local; Operative Time; Postoperative Complications; Retrospective Studies; Surgical Oncology; Treatment Outcome
DOI:
10.21873/anticanres.11468
