Local excision as a treatment for tumors of ampulla of Vater

• Main Authors: Kanellos Ioannis, Sapidis Nikolaos, Pramateftakis Manousos-Georgios, Kirou Ioanna, Zacharakis Emmanouil, Demetriades Haralampos, Betsis Dimitrios
• Format: Article
• Language: English
• Published: BMC 2006-03-01
• Series: World Journal of Surgical Oncology
• Online Access: http://www.wjso.com/content/4/1/14

<p>Abstract</p> <p>Background</p> <p>Although local excision (ampullectomy) was first described by Halsted in 1899, its adequacy as an alternative surgical treatment for the ampullary tumors is still a matter of debate. The aim of this study was to evaluate the results of ampullectomy as a curative treatment for benign and malignant tumors arising from the ampulla, in a 14-year single-institution experience.</p> <p>Methods</p> <p>From 1990 to 2004, a total of 20 patients of adenocarcinoma (12) or adenoma (8) of the ampulla of Vater underwent local excision. Clinical data were collected and morbidity, mortality, as well as long-term survival were evaluated. The usefulness of several pre or intraoperative diagnostic methods was also recorded. Median follow-up was 85 (range 6–180) months.</p> <p>Results</p> <p>The combination of endoscopic preoperative biopsies and intraoperative frozen section examination adequately diagnosed ampullary tumors in all cases. The postoperative morbidity and mortality were 0%, whereas the 3 and 5-year survival rates for the patients with adenocarcinoma was 75 % and 33.3 % respectively. All the patients with adenoma are still alive without any sign of recurrence.</p> <p>Conclusion</p> <p>In our series, local excision was a safe option, associated with satisfactory long-term survival rates in patients with benign lesions and in those with small(<2 cm), pT1, well differentiated ampullary tumours without nodal involvement.</p>