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Duodenal Adenomas in Familial Adenomatous Polyposis

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Hereditary Colorectal Cancer

Part of the book series: M.D. Anderson Solid Tumor Oncology Series ((MDA,volume 5))

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Abstract

Duodenal disease is becoming an increasingly important cause of morbidity and mortality in patients with FAP. Our current understanding of these lesions is poor and the reason for the lower malignant potential of duodenal polyps compared to colonic polyps in FAP is unexplained. In this chapter we review our current understanding of duodenal disease in FAP, its epidemiology, aetiology and natural history. We describe the sparse evidence regarding the management of these lesions and provide our recommendations for surveillance and management.

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References

  1. Hauser G. Uber polyposis intestinalis adenomatosa und deren Beziehungen zur Krebsentwicklung. Duetsche Arc Klim Med. 1895;55:429–48.

    Google Scholar 

  2. Jagelman DG, DeCosse JJ, Bussey HJR, Group LCP. Upper gastrointestinal cancer in familial adenomatous polyposis. Lancet. 1988;1:1149–51.

    Article  PubMed  CAS  Google Scholar 

  3. Spigelman AD, Williams CB, Talbot IC, Domizio P, Phillips RKS. Upper gastrointestinal cancer in patients with familial adenomatous polyposis. Lancet. 1989;2:783–5.

    Article  PubMed  CAS  Google Scholar 

  4. Offerhaus GJ, Giardiello FM, Krush AJ, Booker SV, Tersmette AC, Kelley NC, et al. The risk of upper gastrointestinal cancer in familial adenomatous polyposis. Gastroenterology. 1992;102(6):1980–2 [see comments].

    PubMed  CAS  Google Scholar 

  5. Arvanitis ML, Jagelman DG, Fazio VW, Lavery IC, McGannon E. Mortality in patients with familial adenomatous polyposis. Dis Colon Rectum. 1990;33(8):639–42.

    Article  PubMed  CAS  Google Scholar 

  6. Bulow S, Alm T, Fausa O, Hultcrantz R, Jarvinen H, Vasen H. Duodenal adenomatosis in familial adenomatous polyposis. DAF Project Group. Int J Colorectal Dis. 1995;10(1):43–6.

    Article  PubMed  CAS  Google Scholar 

  7. Belchetz LA, Berk T, Bapat BV, Cohen Z, Gallinger S. Changing causes of mortality in patients with familial adenomatous polyposis. Dis Colon Rectum. 1996;39(4):384–7.

    Article  PubMed  CAS  Google Scholar 

  8. Tonelli F, Nardi F, Bechi P, Taddei G, Gozzo P, Romagnoli P. Extracolonic polyps in familial polyposis coli and Gardner’s syndrome. Dis Colon Rectum. 1985;28(9):664–8.

    Article  PubMed  CAS  Google Scholar 

  9. Sarre RG, Frost AG, Jagelman DG, Petras RE, Sivak MV, McGannon E. Gastric and duodenal polyps in familial adenomatous polyposis: a prospective study of the nature and prevalence of upper gastrointestinal polyps. Gut. 1987;28(3):306–14.

    Article  PubMed  CAS  Google Scholar 

  10. Iida M, Yao T, Itoh H, Watanabe H, Matsui T, Iwashita A, et al. Natural history of duodenal lesions in Japanese patients with familial adenomatosis coli (Gardner’s syndrome). Gastroenterology. 1989;96(5 Pt 1):1301–6.

    PubMed  CAS  Google Scholar 

  11. Domizio P, Talbot IC, Spigelman AD, Williams CB, Phillips RK. Upper gastrointestinal pathology in familial adenomatous polyposis: results from a prospective study of 102 patients. J Clin Pathol. 1990;43(9):738–43.

    Article  PubMed  CAS  Google Scholar 

  12. Bulow S, Bjork J, Christensen IJ, Fausa O, Jarvinen H, Moesgaard F, et al. Duodenal adenomatosis in familial adenomatous polyposis. Gut. 2004;53(3):381–6.

    Article  PubMed  CAS  Google Scholar 

  13. Nugent KP, Spigelman AD, Phillips RK. Life expectancy after colectomy and ileorectal anastomosis for familial adenomatous polyposis. Dis Colon Rectum. 1993;36(11):1059–62.

    Article  PubMed  CAS  Google Scholar 

  14. Bertario L, Presciuttini S, Sala P, Rossetti C, Pietroiusti M. Causes of death and postsurgical survival in familial adenomatous polyposis: results from the Italian Registry. Italian Registry of Familial Polyposis Writing Committee. Semin Surg Oncol. 1994;10(3):225–34.

    Article  PubMed  CAS  Google Scholar 

  15. Vasen HF, Bulow S, Myrhoj T, Mathus-Vliegen L, Griffioen G, Buskens E, et al. Decision analysis in the management of duodenal adenomatosis in familial adenomatous polyposis. Gut. 1997;40(6):716–9 [see comments].

    Article  PubMed  CAS  Google Scholar 

  16. Bjork J, Akerbrant H, Iselius L, Bergman A, Engwall Y, Wahlstrom J, et al. Periampullary adenomas and adenocarcinomas in familial adenomatous polyposis: cumulative risks and APC gene mutations. Gastroenterology. 2001;121(5):1127–35.

    Article  PubMed  CAS  Google Scholar 

  17. Burke CA, Beck GJ, Church JM, van Stolk RU. The natural history of untreated duodenal and ampullary adenomas in patients with familial adenomatous polyposis followed in an endoscopic surveillance program. Gastrointest Endosc. 1999;49(3 Pt 1):358–64.

    Article  PubMed  CAS  Google Scholar 

  18. Spigelman AD, Crofton-Sleigh C, Venitt S, Phillips RK. Mutagenicity of bile and duodenal adenomas in familial adenomatous polyposis. Br J Surg. 1990;77(8):878–81.

    Article  PubMed  CAS  Google Scholar 

  19. Spigelman AD, Owen RW, Hill MJ, Phillips RK. Biliary bile acid profiles in familial adenomatous polyposis. Br J Surg. 1991;78(3):321–5 [see comments].

    Article  PubMed  CAS  Google Scholar 

  20. Spigelman AD, Scates DK, Venitt S, Phillips RKS. DNA adducts, detected by 32P-post labelling, in the foregut of patinets with familial adenomatous polyposis and in unaffected controls. Carcinogenesis. 1991;12:1727–32.

    Article  PubMed  CAS  Google Scholar 

  21. Scates DK, Spigelman AD, Phillips RK, Venitt S. DNA adducts detected by 32P-postlabelling, in the intestine of rats given bile from patients with familial adenomatous polyposis and from unaffected controls. Carcinogenesis. 1992;13(4):731–5.

    Article  PubMed  CAS  Google Scholar 

  22. Scates DK, Spigelman AD, Nugent KP, Phillips RK, Venitt S. DNA adducts, detected by 32P-postlabelling, in DNA treated in vitro with bile from patients with familial adenomatous polyposis and from unaffected controls. Carcinogenesis. 1993;14(6):1107–10.

    Article  PubMed  CAS  Google Scholar 

  23. Mahmoud NN, Dannenberg AJ, Bilinski RT, Mestre JR, Chadburn A, Churchill M, et al. Administration of an unconjugated bile acid increases duodenal tumors in a murine model of familial adenomatous polyposis. Carcinogenesis. 1999;20(2):299–303.

    Article  PubMed  CAS  Google Scholar 

  24. Sanabria JR, Croxford R, Berk TC, Cohen Z, Bapat BV, Gallinger S. Familial segregation in the occurrence and severity of periampullary neoplasms in familial adenomatous polyposis. Am J Surg. 1996;171(1):136–40. discussion 140–1.

    Article  PubMed  CAS  Google Scholar 

  25. Leggett BA, Young JP, Biden K, Buttenshaw RL, Knight N, Cowen AE. Severe upper gastrointestinal polyposis associated with sparse colonic polyposis in a familial adenomatous polyposis family with an APC mutation at codon 1520. Gut. 1997;41(4):518–21.

    Article  PubMed  CAS  Google Scholar 

  26. Bertario L, Russo A, Sala P, et al. Hereditary colorectal tumour registry. Multiple approach to the exploration of the genotype–phenotype correlations in FAP. J Clin Oncol. 2003;21:1698–797.

    Article  PubMed  CAS  Google Scholar 

  27. Groves C, Lamlum H, Crabtree M, Williamson J, Taylor C, Bass S, et al. Mutation cluster region, association between germline and somatic mutations and genotype–phenotype correlation in upper gastrointestinal familial adenomatous polyposis. Am J Pathol. 2002;160(6):2055–61.

    Article  PubMed  CAS  Google Scholar 

  28. Beroud C, Soussi T. APC gene: database of germline and somatic mutations in human tumors and cell lines. Nucleic Acids Res. 1996;24(1):121–4.

    Article  PubMed  CAS  Google Scholar 

  29. Campbell-Thompson M, Lauwers GY, Reyher KK, Cromwell J, Shiverick KT. 17Beta-estradiol modulates gastroduodenal preneoplastic alterations in rats exposed to the carcinogen N-methyl-N′-nitro-nitrosoguanidine. Endocrinology. 1999;140(10):4886–94.

    Article  PubMed  CAS  Google Scholar 

  30. Campbell-Thompson M. Estrogen receptor alpha and beta expression in rat upper gastrointestinal tract with regulation of trefoil family factor 2mRNA levels in ovariectomised rats. Biochem Biophy Res Commun. 1997;240:247–518.

    Article  Google Scholar 

  31. Salih M, Sims SH, Kalu DN. Putative intestinal estrogen receptor: evidence for regional differences. Mol Cell Endocrinol. 1996;121:47–55.

    Article  PubMed  CAS  Google Scholar 

  32. Suraweera N, Haines J, McCart A, Rogers P, Latchford A, Coster M, et al. Genetic determinants modulate susceptibility to pregnancy-associated tumourigenesis in a recombinant line of Min mice. Hum Mol Genet. 2006;15(23):3429–35.

    Article  PubMed  CAS  Google Scholar 

  33. Spigelman AD, Talbot IC, Penna C, Nugent KP, Phillips RK, Costello C, et al. Evidence for adenoma–carcinoma sequence in the duodenum of patients with familial adenomatous polyposis. The Leeds Castle Polyposis Group (Upper Gastrointestinal Committee). J Clin Pathol. 1994;47(8):709–10.

    Article  PubMed  CAS  Google Scholar 

  34. Toyooka M, Konishi M, Kikuchi-Yanoshita R, Iwama T, Miyaki M. Somatic mutations of the adenomatous polyposis coli gene in gastroduodenal tumors from patients with familial adenomatous polyposis. Cancer Res. 1995;55(14):3165–70.

    PubMed  CAS  Google Scholar 

  35. Gallinger S, Vivona AA, Odze RD, Mitri A, O’Beirne CP, Berk TC, et al. Somatic APC and K-ras codon 12 mutations in periampullary adenomas and carcinomas from familial adenomatous polyposis patients. Oncogene. 1995;10(9):1875–8.

    PubMed  CAS  Google Scholar 

  36. Lamlum H, Ilyas M, Rowan A, Clark S, Johnson V, Bell J, et al. The type of somatic mutation at APC in familial adenomatous polyposis is determined by the site of the germline mutation: a new facet to Knudson’s ‘two-hit’ hypothesis. Nat Med. 1999;5(9):1071–5.

    Article  PubMed  CAS  Google Scholar 

  37. Latchford A, Volikos E, Johnson V, et al. APC mutations in FAP-associated desmoid tumours are non-random but not “just right”. Hum Mol Genet. 2007;16(1):78–82.

    Article  PubMed  CAS  Google Scholar 

  38. Kashiwagi H, Spigelman AD, Talbot IC, Debinski HS, McKie AB, Lemoine NR, et al. p53 and K-ras status in duodenal adenomas in familial adenomatous polyposis. Br J Surg. 1997;84(6):826–9.

    Article  PubMed  CAS  Google Scholar 

  39. Achille A, Scupoli MT, Magalini AR, Zamboni G, Romanelli MG, Orlandini S, et al. APC gene mutations and allelic losses in sporadic ampullary tumours: evidence of genetic difference from tumours associated with familial adenomatous polyposis. Int J Cancer. 1996;68(3):305–12.

    Article  PubMed  CAS  Google Scholar 

  40. Kashiwagi H, Spigelman AD, Talbot IC, Phillips RK. Overexpression of p53 in duodenal tumours in patients with familial adenomatous polyposis. Br J Surg. 1996;83(2):225–8.

    Article  PubMed  CAS  Google Scholar 

  41. Takaku K, Oshima M, Miyoshi H, et al. Intestinal tumourigenesis in compound mutatnt mice of both Dpc4 (Smad4) and Apc genes. Cell. 1998;92:645–56.

    Article  PubMed  CAS  Google Scholar 

  42. McCarthy D, Hruban R, Argani P, et al. Role of the DPC4 tumour suppressor gene in adenocarcinoma of the ampulla of Vater: analysis of 140 cases. Mod Pathol. 2003;16:272–8.

    Article  PubMed  Google Scholar 

  43. Brosens L, Iacobuzio-Donahue C, Keller J, et al. Increased COX-2 expression in duodenal compared with colonic tissue in familial adenomatosis polyposis and relationship to the −765G C COX-2 polymorphism. Clin Cancer Res. 2005;11(11):4090–6.

    Article  PubMed  CAS  Google Scholar 

  44. Resnick M, Gallinger S, Wang H, et al. Growth factor expression and proliferation kinetics in periampullary neoplasms in familial adenomatosis polyposis. Cancer. 1995;76:187–94.

    Article  PubMed  CAS  Google Scholar 

  45. Mizumoto I, Ogawa Y, Niiyama H, et al. Possible role of telomerase activation in the multistep tumour progresssion of periampullary lesions in patients with familial adenomatosis polyposis. Am J Gastroenterol. 2001;96(4):1261–5.

    Article  PubMed  CAS  Google Scholar 

  46. Groves CJ, Saunders BP, Spigelman AD, Phillips RK. Duodenal cancer in patients with familial adenomatous polyposis (FAP): results of a 10 year prospective study. Gut. 2002;50(5):636–41.

    Article  PubMed  CAS  Google Scholar 

  47. Chan C, Herrera M, Garza L, et al. Clinical behaviour and prognostic factors of periampullary adenocarcinoma. Ann Surg. 1995;222:632–7.

    Article  PubMed  CAS  Google Scholar 

  48. Sarmiento J, Nagorney D, Sarr M, Farnell M. Periampullary cancers: are there differences? Surg Clin North Am. 2001;81:543–55.

    Article  PubMed  CAS  Google Scholar 

  49. Kashiwagi H, Spigelman AD, Debinski HS, Talbot IC, Phillips RK. Surveillance of ampullary adenomas in familial adenomatous polyposis. Lancet. 1993;344(8936):1582 [letter].

    Article  Google Scholar 

  50. Latchford A, Neale K, Phillips R, Clark S. A single center experience of duodenal cancer in FAP. Abstract. Yokohama: International Society for Gastrointestinal Hereditary Tumours; 2007.

    Google Scholar 

  51. de Vos tot Nederveen Cappel W, Jarvinen H, Bjork J, et al. Worldwide survey among polyposis registries of surgical management of severe duodenal adenomatosis in familial adenomatous polyposis. Br J Surg. 2003;90:705–10.

    Article  Google Scholar 

  52. Gallagher M, Shankar A, Groves C, et al. Pylorus-preserving pancreaticoduodenectomy for advanced duodenal disease in familial adenomatous polyposis. Br J Surg. 2004;91:1157–64.

    Article  PubMed  CAS  Google Scholar 

  53. Nugent KP, Spigelman AD, Williams CB, Talbot IC, Phillips RK. Surveillance of duodenal polyps in familial adenomatous polyposis: progress report. J R Soc Med. 1994;87(11):704–6.

    PubMed  CAS  Google Scholar 

  54. Nugent KP, Farmer KCR, Spigelman AD, Williams CB, Phillips RKS. Randomized controlled trial of the effect of sulindac on duodenal and rectal polyposis and cell proliferation in patients with familial adenomatous polyposis. Br J Surg. 1993;80(12):1618–9.

    Article  PubMed  CAS  Google Scholar 

  55. Giardello FM, Hamilton SR, Krush AJ, Piantadosi S, Hylind LM, Celano P, et al. Treatment of colonic and rectal adenomas with sulindac in familial adenomatous polyposis. N Engl J Med. 1993;328(18):1313–6.

    Article  Google Scholar 

  56. Steinbach G, Lynch PM, Phillips RK, Wallace MH, Hawk E, Gordon GB, et al. The effect of celecoxib, a cyclooxygenase-2 inhibitor, in familial adenomatous polyposis. N Engl J Med. 2000;342(26):1946–52.

    Article  PubMed  CAS  Google Scholar 

  57. Seow-Choen F, Vijayan V, Keng V. Prospective randomized study of sulindac versus calcium and calciferol for upper gastrointestinal polyps in familial adenomatous polyposis. Br J Surg. 1996;83(12):1763–6.

    Article  PubMed  CAS  Google Scholar 

  58. Richard CS, Berk T, Bapat BV, Haber G, Cohen Z, Gallinger S. Sulindac for periampullary polyps in FAP patients. Int J Colorectal Dis. 1997;12(1):14–8.

    Article  PubMed  CAS  Google Scholar 

  59. Winde G, Schmid KW, Brandt B, Muller O, Osswald H. Clinical and genomic influence of sulindac on rectal mucosa in familial adenomatous polyposis. Dis Colon Rectum. 1997;40(10):1156–68. discussion: 1168–9.

    Article  PubMed  CAS  Google Scholar 

  60. Maclean A, McLeod R, Berk T, et al. A randomised trial comparing ursodeoxycholic acid and rofecoxib, a selective COX-2 inhibitor, in the treatment of advanced duodenal adenomas in patients with familial adenomatous polyposis. Gastroenterology. 2001;120 Suppl 1:A-254.

    Google Scholar 

  61. Phillips RK, Wallace MH, Lynch PM, Hawk E, Gordon GB, Saunders BP, et al. A randomised, double blind, placebo controlled study of celecoxib, a selective cyclooxygenase 2 inhibitor, on duodenal polyposis in familial adenomatous polyposis. Gut. 2002;50(6):857–60.

    Article  PubMed  CAS  Google Scholar 

  62. Fries S, Grosser T, Price T, et al. Marked interindividual variability in the response to selective inhibitors of cyclooxygenase-2. Gastroenterology. 2006;130(1):55–64.

    Article  PubMed  CAS  Google Scholar 

  63. Halushka M, Walker L, Halushka P. Genetic variation in cyclooxygenase 1: effects on response to aspirin. Clin Pharmacol Ther. 2003;73(1):122–30.

    Article  PubMed  CAS  Google Scholar 

  64. Scates D, Venitt S, Phillips R, Spigelman A. High pH reduces DNA damage caused by bile from patients with familial adenomatous polyposis: antacids may attenuate duodenal polyposis. Gut. 1995;36(6):918–21.

    Article  PubMed  CAS  Google Scholar 

  65. Wallace MH, Forbes A, Beveridge IG, Spigelman AD, Hewer A, Venitt S, et al. Randomized, placebo-controlled trial of gastric acid-lowering therapy on duodenal polyposis and relative adduct labeling in familial adenomatous polyposis. Dis Colon Rectum. 2001;44(11):1585–9.

    Article  PubMed  CAS  Google Scholar 

  66. Jacoby RF, Cole CE, Tutsch K, Newton MA, Kelloff G, Hawk ET, et al. Chemopreventive efficacy of combined piroxicam and difluoromethylornithine treatment of Apc mutant Min mouse adenomas, and selective toxicity against Apc mutant embryos. Cancer Res. 2000;60(7):1864–70.

    PubMed  CAS  Google Scholar 

  67. Cruz-Correa M, Shoskes D, Sanchez P, et al. Combination treatment with curcumin and quercetin of adenomas in familial adenomatous polyposis. Clin Gastroenterol Hepatol. 2006;4(8):1035–8.

    Article  PubMed  CAS  Google Scholar 

  68. Penna C, Phillips RK, Tiret E, Spigelman AD. Surgical polypectomy of duodenal adenomas in familial adenomatous polyposis: experience of two European centres. Br J Surg. 1993;80(8):1027–9.

    Article  PubMed  CAS  Google Scholar 

  69. Penna C, Bataille N, Balladur P, et al. Surgical treatmnet of severe duodenal polyposis in familial adenomatous polyposis. Br J Surg. 1998;85(5):665–8.

    Article  PubMed  CAS  Google Scholar 

  70. Heiskanen I, Kellokumpu I, Jarvinen H. Management of duodenal adenomas in 98 patients with familial adenomatous polyposis. Endoscopy. 1999;31(6):412–6.

    Article  PubMed  CAS  Google Scholar 

  71. Soravia C, Berk T, Haber G, et al. Management of advanced duodenal polyposis in familial adenomatous polyposis. J Gastrointest Surg. 1997;1(5):474–8.

    Article  PubMed  CAS  Google Scholar 

  72. Ouaissi M, Panis Y, Sielezneff I, et al. Long-term outcome after ampullectomy for ampullary lesions associated with familial adenomatous polyposis. Dis Colon Rectum. 2005;5:187–95.

    Google Scholar 

  73. Mackey R, Walsh M, Chung R, et al. Pancreas-sparing duodenectomy is effective management for familial adenomatous polyposis. J Gastrointest Surg. 2005;9(8):1088–93.

    Article  PubMed  Google Scholar 

  74. Latchford A, Gallagher M, Neale K, Phillips R. A review of endoscopic follow up of postoperative duodenal adenomas in FAP. Familial Cancer. 2005;4 Suppl 1:P75.

    Google Scholar 

  75. Murakami Y, Uemura K, Sasaki M, et al. Duodenal cancer arising from the remaining duodenum after pylorus-preserving pancreatoduodenectomy for ampullary cancer in familial adenomatous polyposis. J Gastrointest Surg. 2005;9(3):389–92.

    Article  PubMed  Google Scholar 

  76. Norton ID, Geller A, Petersen BT, Sorbi D, Gostout CJ. Endoscopic surveillance and ablative therapy for periampullary adenomas. Am J Gastroenterol. 2001;96(1):101–6.

    Article  PubMed  CAS  Google Scholar 

  77. Catalano M, Linder J, Chak A, et al. Endoscopic management of adenoma of the major duodenal papilla. Gastrointest Endosc. 2004;59(2):225–32.

    Article  PubMed  Google Scholar 

  78. Latchford A, Gallagher M, Newton D, et al. Endoscopic therapy for duodenal adenomas in familial adenomatous polyposis. Yokohama: International Society for Gastrointestinal Hereditary Tumours; 2007.

    Google Scholar 

  79. Mlkvy P, Messmann H, Debinski H, Regula J, Conio M, MacRobert A, et al. Photodynamic therapy for polyps in familial adenomatous polyposis – a pilot study. Eur J Cancer. 1995;31A(7–8):1160–5.

    PubMed  CAS  Google Scholar 

  80. Regula J, MacRobert A, Gorchevin A, et al. Photosensitisation and photodynamic therapy of oesophageal, duodenal and colorectal tumours using 5 aminolavulinic acid induced protoporphyrin IX – a pilot study. Gut. 1995;36:67–75.

    Article  PubMed  CAS  Google Scholar 

  81. Nugent KP, Spigelman AD, Williams CB, Phillips RK. Iatrogenic pancreatitis in familial adenomatous polyposis. Gut. 1993;34(9):1269–70.

    Article  PubMed  CAS  Google Scholar 

  82. Marpugo E, Vitale G, Galandiuk S, et al. Clinical characteristics of familial adenomatous polyposis and management of duodenal adenomas. J Gastrointest Surg. 2004;8:559–64.

    Article  Google Scholar 

  83. Alarcon FJ, Burke CA, Church JM, van Stolk RU, Williams CS, Mann M, et al. Familial adenomatous polyposis – efficacy of endoscopic and surgical treatment for advanced duodenal adenomas. The role of cyclooxygenases in inflammation, cancer, and development. Dis Colon Rectum. 1999;42(12):1533–6.

    Article  PubMed  CAS  Google Scholar 

  84. Penna C, Bataille N, Balladur P, Tiret E, Parc R. Surgical treatment of severe duodenal polyposis in familial adenomatous polyposis. Br J Surg. 1998;85(5):665–8.

    Article  PubMed  CAS  Google Scholar 

  85. Ruo L, Coit DG, Brennan MF, Guillem JG. Long-term follow-up of patients with familial adenomatous polyposis undergoing pancreaticoduodenal surgery. J Gastrointest Surg. 2002;6(5):671–5.

    Article  PubMed  Google Scholar 

  86. Chung RS, Church JM, van Stolk R. Pancreas-sparing duodenectomy: indications, surgical technique, and results. Surgery. 1995;117(3):254–9.

    Article  PubMed  CAS  Google Scholar 

  87. Kalady MF, Clary BM, Tyler DS, Pappas TN. Pancreas-preserving duodenectomy in the management of duodenal familial adenomatous polyposis. J Gastrointest Surg. 2002;6(1):82–7.

    Article  PubMed  Google Scholar 

  88. Balladur P, Penna C, Tiret E, Vaillant JC, Gailleton R, Parc R. Pancreatico-duodenectomy for cancer and precancer in familial adenomatous polyposis. Int J Colorectal Dis. 1993;8(3):151–3.

    Article  PubMed  CAS  Google Scholar 

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Latchford, A., Saunders, B. (2010). Duodenal Adenomas in Familial Adenomatous Polyposis. In: Rodriguez-Bigas, M., Cutait, R., Lynch, P., Tomlinson, I., Vasen, H. (eds) Hereditary Colorectal Cancer. M.D. Anderson Solid Tumor Oncology Series, vol 5. Springer, Boston, MA. https://doi.org/10.1007/978-1-4419-6603-2_12

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