家族性腺瘤性息肉病中十二指肠和壶腹腺瘤病的胰十二指肠切除术。
Pancreaticoduodenectomy for advanced duodenal and ampullary adenomatosis in familial adenomatous polyposis.
机构信息
Department of Hepatobiliary and Pancreatic Surgery, Royal Free Hampstead National Health Service (NHS) Trust, London, UK.
出版信息
HPB (Oxford). 2011 May;13(5):342-9. doi: 10.1111/j.1477-2574.2011.00292.x. Epub 2011 Mar 10.
Abstract
BACKGROUND
Patients with familial adenomatous polyposis (FAP) develop duodenal and ampullary polyps that may progress to malignancy via the adenoma-carcinoma sequence.
OBJECTIVE
The aim of this study was to review a large series of FAP patients undergoing pancreaticoduodenectomy for advanced duodenal and ampullary polyposis.
METHODS
A retrospective case notes review of all FAP patients undergoing pancreaticoduodenectomy for advanced duodenal and ampullary adenomatosis was performed.
RESULTS
Between October 1993 and January 2010, 38 FAP patients underwent pancreaticoduodenectomy for advanced duodenal and ampullary polyps. Complications occurred in 29 patients and perioperative mortality in two. Postoperative histology revealed five patients to have preoperatively undetected cancer (R = 0.518, P < 0.001).
CONCLUSIONS
Pancreaticoduodenectomy in FAP is associated with significant morbidity, but low mortality. All patients under consideration for operative intervention require careful preoperative counselling and optimization.
摘要
背景
家族性腺瘤性息肉病（FAP）患者会出现十二指肠和壶腹息肉，这些息肉可能会通过腺瘤-癌序列进展为恶性肿瘤。
目的
本研究旨在回顾分析一组因进展期十二指肠和壶腹腺瘤而接受胰十二指肠切除术的 FAP 患者。
方法
对 1993 年 10 月至 2010 年 1 月间因进展期十二指肠和壶腹腺瘤而接受胰十二指肠切除术的所有 FAP 患者的病例记录进行回顾性分析。
结果
1993 年 10 月至 2010 年 1 月间，38 例 FAP 患者因进展期十二指肠和壶腹腺瘤而接受胰十二指肠切除术。29 例患者发生并发症，2 例围手术期死亡。术后组织学检查显示 5 例患者术前未检出癌症（R = 0.518，P < 0.001）。
结论
FAP 患者行胰十二指肠切除术相关发病率高，但死亡率低。所有考虑手术干预的患者均需要仔细的术前咨询和优化。
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