Table 5

 Local surgical treatment (duodenotomy with polypectomy and/or ampullectomy) for duodenal neoplastic lesions

AuthorTreatmentFollow upPatientsOutcomePostoperative
*That is, wound infection, atelectasis, or urinary tract infection.
NS, not stated; FAP, familial adenomatous polyposis.
Soravia52Duodenotomy with polypectomy (1) or ampullectomy (4)4–34 months
>(mean 18)
5 FAPRecurrence in 4 patients. 1 patient died of cancer1 transient duodenal fistula
Morpurgo44Transduodenal ampullectomy (1) or polyp excision (1)6–24 months
>(mean 19)
2 FAPRecurrence in 1 patient1 severe pancreatitis
Alarcon46Local resection8–33 months
>(mean 20.2)
5 FAPRecurrence in 4 patients. 1 had progressive metastatic adenocarcinomaNS
Heiskanen5Duodenotomy0.4–15.1 years
>(median 6.8)
15 FAPNo significant difference in Spigelman stage preoperative and at latest endoscopyNo postoperative complications
Penna56Duodenotomy with polypectomy5–36 months
>(mean 13.3)
12 FAPRecurrence in 12 patientsNS
Penna57Duodenotomy with polypectomy36–72 months
>(mean 53)
6 FAPRecurrence in 6 patients1 cholecystectomy for cholecystitis, 2 duodenal fistulas
de Vos tot Nederveen58Duodenotomy with ampullectomy4–13 months
>(mean 11)
8 FAPRecurrence in 6 patients1 minor morbidity*
de Vos tot Nederveen58Duodenotomy with polypectomy5–103 months
>(mean 29)
22 FAPRecurrence in 17 patients. 1 death from metastatic disease1 minor morbidity*
Ruo59Duodenotomy with ampullectomy35 months1 FAPGastric cancer arising from a polyp at 35 monthsNo postoperative complications
Farnell60Transduodenal local excision10 years53 sporadic and FAP patientsRecurrence rate of 32% at 5 years and 43% at 10 years of follow up3 pancreatitis, 3 leaks, 2 delayed gastric emptying, 2 ileus, 1 fluid overload