{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T06:59:35Z","timestamp":1761893975220},"reference-count":44,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2004,7,26]],"date-time":"2004-07-26T00:00:00Z","timestamp":1090800000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2004,8,20]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Although only 5 per cent of patients with familial adenomatous polyposis (FAP) die from duodenal cancer, a recent study indicated that the mortality rate is much higher in patients with Spigelman stage IV disease. This has prompted an increased rate of referral for excisional surgery and an analysis of the results.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Between January 1994 and June 2002, 16 patients with FAP (mean age 55 years; eight men) were referred to a single surgeon for pylorus-preserving pancreaticoduodenal resection for Spigelman stage IV duodenal adenomatosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>One patient died from multiple organ failure after relaparotomy for haemorrhage and a jejunal perforation; other major complications included anastomotic leak (one), primary haemorrhage (one), lymphatic leak (one), chylous ascites (one), pulmonary embolus (two) and prolonged delayed gastric emptying that required total parenteral nutrition (three). Overall there were 11 major complications in eight patients. Two patients developed insulin-dependent diabetes and one postprandial dumping. Postoperative histological examination revealed five unsuspected cancers, which led to four deaths within 3 years of surgery. One patient died 2 months after surgery from pulmonary thromboembolism and another at 5 months from an inoperable brain tumour. Nine of the 16 patients were alive and well at a mean of 38 months after surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The choice between continued endoscopic surveillance and excisional surgery for Spigelman stage IV duodenal disease remains finely balanced.<\/jats:p><\/jats:sec>","DOI":"10.1002\/bjs.4527","type":"journal-article","created":{"date-parts":[[2004,7,26]],"date-time":"2004-07-26T16:00:44Z","timestamp":1090857644000},"page":"1157-1164","source":"Crossref","is-referenced-by-count":49,"title":["Pylorus-preserving pancreaticoduodenectomy for advanced duodenal disease in familial adenomatous polyposis"],"prefix":"10.1093","volume":"91","author":[{"given":"M C","family":"Gallagher","sequence":"first","affiliation":[{"name":"The Polyposis Registry, St Mark's Hospital, Harrow, UK"},{"name":"Cancer Research UK, Colorectal Cancer Unit, St Mark's Hospital, Harrow, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A","family":"Shankar","sequence":"additional","affiliation":[{"name":"Hepato-pancreatobiliary and Endocrine Surgical Unit, The Middlesex Hospital, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C J","family":"Groves","sequence":"additional","affiliation":[{"name":"The Polyposis Registry, St Mark's Hospital, Harrow, UK"},{"name":"Cancer Research UK, Colorectal Cancer Unit, St Mark's Hospital, Harrow, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R C G","family":"Russell","sequence":"additional","affiliation":[{"name":"Hepato-pancreatobiliary and Endocrine Surgical Unit, The Middlesex Hospital, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R K S","family":"Phillips","sequence":"additional","affiliation":[{"name":"The Polyposis Registry, St Mark's Hospital, Harrow, UK"},{"name":"Cancer Research UK, Colorectal Cancer Unit, St Mark's Hospital, Harrow, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2004,7,26]]},"reference":[{"key":"2021070911532246100_bib1","volume-title":"Familial Polyposis Coli: Family Studies, Histopathology, Differential Diagnosis, and Results of Treatment","author":"Bussey","year":"1975"},{"key":"2021070911532246100_bib2","doi-asserted-by":"crossref","first-page":"1980","DOI":"10.1016\/0016-5085(92)90322-P","article-title":"The risk of upper gastrointestinal cancer in familial adenomatous polyposis","volume":"102","author":"Offerhaus","year":"1992","journal-title":"Gastroenterology"},{"key":"2021070911532246100_bib3","doi-asserted-by":"crossref","first-page":"1059","DOI":"10.1007\/BF02047300","article-title":"Life expectancy after colectomy and ileorectal anastomosis for familial adenomatous polyposis","volume":"36","author":"Nugent","year":"1993","journal-title":"Dis Colon Rectum"},{"key":"2021070911532246100_bib4","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1136\/jcp.47.8.709","article-title":"Evidence for adenoma\u2013carcinoma sequence in the duodenum of patients with familial adenomatous polyposis. The Leeds Castle Polyposis Group (Upper Gastrointestinal Committee)","volume":"47","author":"Spigelman","year":"1994","journal-title":"J Clin Pathol"},{"key":"2021070911532246100_bib5","doi-asserted-by":"crossref","first-page":"376","DOI":"10.3109\/00365529609006414","article-title":"Adenoma\u2013carcinoma sequence in the papilla of Vater","volume":"31","author":"Stolte","year":"1996","journal-title":"Scand J Gastroenterol"},{"key":"2021070911532246100_bib6","first-page":"1566","article-title":"Malignant change in a duodenal adenoma in familial adenomatous polyposis: report of a case","volume":"93","author":"Nakatsubo","year":"1998","journal-title":"Am J Gastroenterol"},{"key":"2021070911532246100_bib7","doi-asserted-by":"crossref","first-page":"639","DOI":"10.1007\/BF02150736","article-title":"Mortality in patients with familial adenomatous polyposis","volume":"33","author":"Arvanitis","year":"1990","journal-title":"Dis Colon Rectum"},{"key":"2021070911532246100_bib8","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1007\/BF02054051","article-title":"Changing causes of mortality in patients with familial adenomatous polyposis","volume":"39","author":"Belchetz","year":"1996","journal-title":"Dis Colon Rectum"},{"key":"2021070911532246100_bib9","doi-asserted-by":"crossref","first-page":"783","DOI":"10.1016\/S0140-6736(89)90840-4","article-title":"Upper gastrointestinal cancer in patients with familial adenomatous polyposis","volume":"ii","author":"Spigelman","year":"1989","journal-title":"Lancet"},{"key":"2021070911532246100_bib10","doi-asserted-by":"crossref","first-page":"716","DOI":"10.1136\/gut.40.6.716","article-title":"Decision analysis in the management of duodenal adenomatosis in familial adenomatous polyposis","volume":"40","author":"Vasen","year":"1997","journal-title":"Gut"},{"key":"2021070911532246100_bib11","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1007\/s003840050129","article-title":"Prophylactic pancreaticoduodenectomy for premalignant duodenal polyposis in familial adenomatous polyposis","volume":"13","author":"Causeret","year":"1998","journal-title":"Int J Colorectal Dis"},{"key":"2021070911532246100_bib12","doi-asserted-by":"crossref","first-page":"1127","DOI":"10.1053\/gast.2001.28707","article-title":"Periampullary adenomas and adenocarcinomas in familial adenomatous polyposis: cumulative risks and APC gene mutations","volume":"121","author":"Bjork","year":"2001","journal-title":"Gastroenterology"},{"key":"2021070911532246100_bib13","doi-asserted-by":"crossref","first-page":"636","DOI":"10.1136\/gut.50.5.636","article-title":"Duodenal cancer in patients with familial adenomatous polyposis (FAP): results of a 10 year prospective study","volume":"50","author":"Groves","year":"2002","journal-title":"Gut"},{"key":"2021070911532246100_bib14","doi-asserted-by":"crossref","first-page":"1027","DOI":"10.1002\/bjs.1800800833","article-title":"Surgical polypectomy of duodenal adenomas in familial adenomatous polyposis: experience of two European centres","volume":"80","author":"Penna","year":"1993","journal-title":"Br J Surg"},{"key":"2021070911532246100_bib15","doi-asserted-by":"crossref","first-page":"704","DOI":"10.1177\/014107689408701123","article-title":"Surveillance of duodenal polyps in familial adenomatous polyposis: progress report","volume":"87","author":"Nugent","year":"1994","journal-title":"J R Soc Med"},{"key":"2021070911532246100_bib16","doi-asserted-by":"crossref","first-page":"808","DOI":"10.1080\/003655299750025741","article-title":"Causes of death in familial adenomatous polyposis","volume":"34","author":"Galle","year":"1999","journal-title":"Scand J Gastroenterol"},{"key":"2021070911532246100_bib17","doi-asserted-by":"crossref","first-page":"1149","DOI":"10.1016\/S0140-6736(88)91962-9","article-title":"Upper gastrointestinal cancer in familial adenomatous polyposis","volume":"i","author":"Jagelman","year":"1988","journal-title":"Lancet"},{"key":"2021070911532246100_bib18","doi-asserted-by":"crossref","first-page":"825","DOI":"10.1001\/archsurg.1991.01410310035004","article-title":"Prognosis of symptomatic duodenal adenomas in familial adenomatous polyposis","volume":"126","author":"Beckwith","year":"1991","journal-title":"Arch Surg"},{"key":"2021070911532246100_bib19","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1177\/014107689208500208","article-title":"Rectal polyposis as a guide to duodenal polyposis in familial adenomatous polyposis","volume":"85","author":"Spigelman","year":"1992","journal-title":"J R Soc Med"},{"key":"2021070911532246100_bib20","doi-asserted-by":"crossref","first-page":"518","DOI":"10.1136\/gut.41.4.518","article-title":"Severe upper gastrointestinal polyposis associated with sparse colonic polyposis in a familial adenomatous polyposis family with an APC mutation at codon 1520","volume":"41","author":"Leggett","year":"1997","journal-title":"Gut"},{"key":"2021070911532246100_bib21","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1016\/S0002-9610(99)80088-9","article-title":"Familial segregation in the occurrence and severity of periampullary neoplasms in familial adenomatous polyposis","volume":"171","author":"Sanabria","year":"1996","journal-title":"Am J Surg"},{"key":"2021070911532246100_bib22","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1007\/s10350-004-6153-9","article-title":"Progressive duodenal adenomatosis in a familial adenomatous polyposis pedigree with APC mutation at codon 1556","volume":"45","author":"Matsumoto","year":"2002","journal-title":"Dis Colon Rectum"},{"key":"2021070911532246100_bib23","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1007\/BF00337586","article-title":"Duodenal adenomatosis in familial adenomatous polyposis. DAF Project Group","volume":"10","author":"Bulow","year":"1995","journal-title":"Int J Colorectal Dis"},{"key":"2021070911532246100_bib24","doi-asserted-by":"crossref","first-page":"358","DOI":"10.1016\/S0016-5107(99)70013-1","article-title":"The natural history of untreated duodenal and ampullary adenomas in patients with familial adenomatous polyposis followed in an endoscopic surveillance program","volume":"49","author":"Burke","year":"1999","journal-title":"Gastrointest Endosc"},{"key":"2021070911532246100_bib25","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1007\/s003840100290","article-title":"Duodenal adenomatosis in familial adenomatous polyposis coli. A review of the literature and results from the Heidelberg Polyposis Register","volume":"16","author":"Kadmon","year":"2001","journal-title":"Int J Colorectal Dis"},{"key":"2021070911532246100_bib26","doi-asserted-by":"crossref","first-page":"948","DOI":"10.1002\/bjs.1800840711","article-title":"Local resection or pancreaticoduodenectomy for villous adenoma of the ampulla of Vater diagnosed before operation","volume":"84","author":"Cahen","year":"1997","journal-title":"Br J Surg"},{"key":"2021070911532246100_bib27","first-page":"225","article-title":"Overexpression of p53 in duodenal tumours in patients with familial adenomatous polyposis","volume":"83","author":"Kashiwagi","year":"1996","journal-title":"Br J Surg"},{"key":"2021070911532246100_bib28","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1016\/S0002-9610(00)00379-2","article-title":"Defining a role for endoscopic ultrasound in staging periampullary tumors","volume":"179","author":"Shoup","year":"2000","journal-title":"Am J Surg"},{"key":"2021070911532246100_bib29","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1016\/S0002-9610(01)00707-3","article-title":"Is a preoperative multidiagnostic approach to predict surgical resectability of periampullary tumors still effective?","volume":"182","author":"Schwarz","year":"2001","journal-title":"Am J Surg"},{"key":"2021070911532246100_bib30","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1259\/bjr.72.857.10505006","article-title":"Pre-operative staging of ampullary tumours by endoscopic ultrasound","volume":"72","author":"Kubo","year":"1999","journal-title":"Br J Radiol"},{"key":"2021070911532246100_bib31","doi-asserted-by":"crossref","first-page":"1618","DOI":"10.1002\/bjs.1800801244","article-title":"Randomized controlled trial of the effect of sulindac on duodenal and rectal polyposis and cell proliferation in patients with familial adenomatous polyposis","volume":"80","author":"Nugent","year":"1993","journal-title":"Br J Surg"},{"key":"2021070911532246100_bib32","doi-asserted-by":"crossref","first-page":"1763","DOI":"10.1002\/bjs.1800831232","article-title":"Prospective randomized study of sulindac versus calcium and calciferol for upper gastrointestinal polyps in familial adenomatous polyposis","volume":"83","author":"Seow-Choen","year":"1996","journal-title":"Br J Surg"},{"key":"2021070911532246100_bib33","doi-asserted-by":"crossref","first-page":"1585","DOI":"10.1007\/BF02234376","article-title":"Randomized, placebo-controlled trial of gastric acid-lowering therapy on duodenal polyposis and relative adduct labeling in familial adenomatous polyposis","volume":"44","author":"Wallace","year":"2001","journal-title":"Dis Colon Rectum"},{"key":"2021070911532246100_bib34","doi-asserted-by":"crossref","first-page":"857","DOI":"10.1136\/gut.50.6.857","article-title":"A randomised, double blind, placebo controlled study of celecoxib, a selective cyclooxygenase 2 inhibitor, on duodenal polyposis in familial adenomatous polyposis","volume":"50","author":"Phillips","year":"2002","journal-title":"Gut"},{"key":"2021070911532246100_bib35","doi-asserted-by":"crossref","first-page":"612","DOI":"10.1136\/gut.47.5.612","article-title":"Photodynamic therapy for dysplastic Barrett's oesophagus: a prospective, double blind, randomised, placebo controlled trial","volume":"47","author":"Ackroyd","year":"2000","journal-title":"Gut"},{"key":"2021070911532246100_bib36","doi-asserted-by":"crossref","first-page":"1989","DOI":"10.1038\/bjc.1998.330","article-title":"Clinical photodynamic therapy for superficial cancer in the oesophagus and the bronchi: 514 nm compared with 630 nm light irradiation after sensitization with Photofrin II","volume":"77","author":"Grosjean","year":"1998","journal-title":"Br J Cancer"},{"key":"2021070911532246100_bib37","doi-asserted-by":"crossref","first-page":"853","DOI":"10.1136\/gut.36.6.853","article-title":"Photodynamic therapy for malignant tumours of the ampulla of Vater","volume":"36","author":"Abulafi","year":"1995","journal-title":"Gut"},{"key":"2021070911532246100_bib38","first-page":"1160","article-title":"Photodynamic therapy for polyps in familial adenomatous polyposis\u2014a pilot study","volume":"31A","author":"Mlkvy","year":"1995","journal-title":"Eur J Cancer"},{"key":"2021070911532246100_bib39","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1046\/j.1365-2168.1998.00684.x","article-title":"Surgical treatment of severe duodenal polyposis in familial adenomatous polyposis","volume":"85","author":"Penna","year":"1998","journal-title":"Br J Surg"},{"key":"2021070911532246100_bib40","doi-asserted-by":"crossref","first-page":"1533","DOI":"10.1007\/BF02236201","article-title":"Familial adenomatous polyposis: efficacy of endoscopic and surgical treatment for advanced duodenal adenomas","volume":"42","author":"Alarcon","year":"1999","journal-title":"Dis Colon Rectum"},{"key":"2021070911532246100_bib41","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1111\/j.1572-0241.2001.03358.x","article-title":"Endoscopic surveillance and ablative therapy for periampullary adenomas","volume":"96","author":"Norton","year":"2001","journal-title":"Am J Gastroenterol"},{"key":"2021070911532246100_bib42","first-page":"462","article-title":"Indications for local excision of ampullary lesions associated with familial adenomatous polyposis","volume":"179","author":"Iwama","year":"1994","journal-title":"J Am Coll Surg"},{"key":"2021070911532246100_bib43","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1001\/archsurg.137.5.557","article-title":"Pancreas-sparing duodenectomy for duodenal polyposis","volume":"137","author":"Sarmiento","year":"2002","journal-title":"Arch Surg"},{"key":"2021070911532246100_bib44","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1016\/S1091-255X(01)00005-1","article-title":"Pancreas-preserving duodenectomy in the management of duodenal familial adenomatous polyposis","volume":"6","author":"Kalady","year":"2002","journal-title":"J Gastrointest Surg"}],"container-title":["British Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fbjs.4527","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/academic.oup.com\/bjs\/article-pdf\/91\/9\/1157\/36730310\/bjs4527.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/bjs\/article-pdf\/91\/9\/1157\/36730310\/bjs4527.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,14]],"date-time":"2024-01-14T00:27:59Z","timestamp":1705192079000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/bjs\/article\/91\/9\/1157\/6143750"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2004,7,26]]},"references-count":44,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2004,7,26]]},"published-print":{"date-parts":[[2004,8,20]]}},"URL":"https:\/\/doi.org\/10.1002\/bjs.4527","relation":{},"ISSN":["0007-1323","1365-2168"],"issn-type":[{"value":"0007-1323","type":"print"},{"value":"1365-2168","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2004,9]]},"published":{"date-parts":[[2004,7,26]]}}}