雑誌文献を検索します。書籍を検索する際には「書籍検索」を選択してください。

検索

書誌情報 詳細検索 by 医中誌

Japanese

Management of Periampullary Lesions in Patients with Familial Adenomatous Polyposis Masazumi Takahashi 1 , Fumihiko Kito 1 , Tsuneo Fukushima 1 1Division of Surgery, Yokohama City Citizen's Hospital Keyword: 家族性大腸腺腫症 , 十二指腸腺腫 , 十二指腸癌 , 十二指腸乳頭部癌 , サーベイランス pp.1127-1135
Published Date 2004/7/25
DOI https://doi.org/10.11477/mf.1403100538
  • Abstract
  • Look Inside
  • Reference

 As the relative risk of periampullary carcinoma is high in patients with familial adenomatous polyposis (FAP), the management of periampullary lesions has been studied as the prognostic factor to treat patients with FAP after prophylactic total colectomy. Surveillance with gastroduodenal endoscopy is important, and careful observation around the papilla of Vater is especially necessary. Severe duodenal polyposis like Spigelman's stage IV and developing ampullary adenomas have high risk of canceration and are indications for prophylactic duodenal surgery. Endoscopic mucosal resection and Argon plasma coagulation may be useful, and their indication and implementation will be further developed. Endoscopic surveillance had limitations for early diagnosis of duodenal cancer, so further study using the molecular-biological approach such as genetic analysis for classification of subgroups with high risk of duodenal cancer is called for. In the future, pylorus-preserving pancreaticoduodenectomy and pancreas-preserving duodenectomy may be the main methods selected for surgical treatment. COX-2 inhibitors have recently been shown to be useful and further development of chemoprevention therapy is looked forward to.

 1) Division of Surgery, Yokohama City Citizen's Hospital, Yokohama, Japan


Copyright © 2004, Igaku-Shoin Ltd. All rights reserved.

基本情報

電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

関連文献

もっと見る

文献を共有