Abstract

BACKGROUND
Laparoscopic surgery has extended its applications to resection of malignancies with favorable results. We report the first successful simultaneous laparoscopic subtotal colectomy and pancreaticoduodenectomy (PD) in a patient with familial adenomatous polyposis (FAP).
CASE REPORT
A 37-year-old man presented with obstructive jaundice. Gastroscopy and biopsies revealed a large ampullary tubulovillous adenoma with mild dysplasia (Spigelman stage III). A colonoscopy for suspicion of FAP revealed numerous right-sided polyps with left-sided sparing. Computed tomography showed a double duct sign. A simultaneous laparoscopic subtotal colectomy and PD was performed successfully. The operative time was 225 minutes for the colectomy and 390 minutes for the PD. Histology showed an R0 resection of ampullary adenocarcinoma (20 negative nodes) and colonic polyps with low-grade dysplasia. Genetic screening confirmed a diagnosis of FAP.
CONCLUSIONS
A simultaneous laparoscopic subtotal colectomy and PD in patients with FAP and ampullary neoplasia seems safe with favorable clinical and oncologic outcomes.

Links

Publisher Full Text

Authors

Khaled YS, Ammori MB, Sharif HI, Ammori BJ

Institution

The University of Manchester, The Department of Hepato-Pancreato-Biliary, North Manchester General Hospital, Manchester, UK.

Source

Surgical laparoscopy, endoscopy & percutaneous techniques 22:2 2012 Apr pg e79-82

MeSH

Adenomatous Polyposis Coli
Adult
Ampulla of Vater
Colectomy
Colonic Neoplasms
Common Bile Duct Neoplasms
Humans
Jaundice, Obstructive
Laparoscopy
Male
Pancreaticoduodenectomy
Treatment Outcome

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

22487645