source: Annals of the royal college of surgeons of England

year: 2009

authors: Liau S S, Jah A, Huguet E, Jamieson N, Praseedom R

BACKGROUND

Peri-ampullary carcinoma is the third leading cause of mortality in patients with familial adenomatous polyposis (FAP), who may, therefore, require a Whipple’s pancreaticoduodenectomy (WPD) as prophylactic or curative measure. However, patients are at risk of further small bowel polyp formation, requiring life-long surveillance with enteroscopy or contrast follow-through. Traditional reconstruction following WPD, with or without a Roux-en-Y loop, makes the subsequent surveillance study difficult due to a part of the small bowel loop being inaccessible. Similarly, the useful small bowel absorptive length is reduced. Here, we describe a reconstruction technique following WPD which facilitates surveillance studies, and conserves absorptive bowel length.