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Duodenal Villous Tumors
Kevin J. Bjork, MD;
Chad J. Davis, MD;
David M. Nagorney, MD;
Peter Mucha, Jr, MD
Arch Surg. 1990;125(8):961-965.
Abstract
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• The treatment of 36 patients with duodenal villous tumors was reviewed to determine the long-term outcome of various surgical treatment options for specific adenoma histopathology. Duodenal villous tumors were typically solitary and periampullary in location. Villous adenomas contained epithelial atypia in 30% of patients, in situ carcinoma in 14%, and invasive carcinoma in 33%. Treatment consisted of transduodenal submucosal excision in 19 patients and radical pancreaticoduodenectomy in 15. There was no perioperative mortality. Perioperative morbidity for transduodenal excision and pancreaticoduodenectomy was 16% and 47%, respectively. Benign adenomas recurred more than 5 years postoperatively in 17% of patients undergoing transduodenal excision. Five-year survival following radical resection for invasive cancers was 45%. Overall median follow-up was 5.8 years. We conclude that duodenal villous tumors without invasive cancer can be managed successfully by local submucosal excision, but invasive carcinoma requires radical resection.
(Arch Surg. 1990;125:961-965)
Author Affiliations
From the Department of Surgery, Mayo Clinic and Foundation, Rochester, Minn.
Footnotes
Accepted for publication April 21, 1990.
Read before the 97th Annual Meeting of the Western Surgical Association, St Louis, Mo, November 14, 1989.
Reprint requests to Department of Surgery, Mayo Clinic, 200 First St SW, Rochester, MN 55905 (Dr Nagorney).
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