FAP مع أورام الاثني عشر الغدية: الإدارة الجراحية عند عدم بلوغ مرحلة Spigelman المستهدفة بالتحجيم التنظيري

References

DOI: 10.1093/bjs/znae263

All gastric adenomas larger >5 mm should undergo endoscopic resection.

All non-papillary duodenal lesions >10 mm should undergo endoscopic resection.

All papillary adenomas should be candidates for endoscopic resection, but especially if harbouring HGD, villous histology, or if >10 mm in size.

All gastric, duodenal and ampullary histologically proven carcinomas with endoscopic features suggestive of invasive adenocarcinoma should undergo surgery with or without systemic therapy, rather than endoscopic resection.

Curative surgical resection must be offered to surgically resectable, histologically proven duodenal and ampullary adenocarcinoma.

Prophylactic surgical resection could be considered for Spigelman stage IV duodenal polyposis.

Pancreato-duodenectomy is the procedure of choice in case of suspected duodenal cancer. For prophylactic surgery, both pancreas-sparing duodenectomy and pancreatico-duodenectomy may be considered.

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