Abstract

BACKGROUND Peri-ampullary carcinoma is the third leading cause of mortality in patients with familial adenomatous polyposis (FAP),1 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.

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