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Laparoscopic total gastrectomy, take down of prior duodenojejunostomy and Roux-en-Y esophagojejunostomy

Tariq Almerey, MD, Javier Arreaza, MD, Horacio J Asbun, MD. Mayo Clinic Florida

Introduction: Familiar adenomatous polyposis (FAP) is the most common inherited adenomatous polyposis syndrome and is caused by a germline mutation of the APC tumor suppressor gene. The average age of onset of polyposis in FAP is 16 years and is primarily characterized by the development of colorectal adenomas. Gastric polyps can develop as well, and recently their malignant potentials have been more clearly recognized.

Case Report: The patient is a 57-year old morbidly obese (BMI 48) female with a history of FAP. She is status post total colectomy with iliorectal anastomosis at age of 13 and pancreas preserving near total duodenectomy for duodenal polyps with pancreato-jejunostomy reconstruction at our institution, at age of 52. Subsequently she continued on regular  endoscopic surveillance which revealed gradually worsening gastric and rectal polyps. On most recent biopsies, atypical cells were reported on random biopsy of the gastric polyps. A Laparoscopic total gastrectomy, take down of prior post pyloric duodenojejunostomy, and Roux-en-Y esophagojejunostomy reconstruction was performed. The stomach measured over 48 centimeters and weighted 2.3 kilograms. The margins were negative for polyps.


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 88675

Program Number: V063

Presentation Session: Thursday Exhibit Hall Theater (Non CME)

Presentation Type: EHVideo

40

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