World Journal of Surgical Oncology (Mar 2006)

Local excision as a treatment for tumors of ampulla of Vater

  • Kanellos Ioannis,
  • Sapidis Nikolaos,
  • Pramateftakis Manousos-Georgios,
  • Kirou Ioanna,
  • Zacharakis Emmanouil,
  • Demetriades Haralampos,
  • Betsis Dimitrios

DOI
https://doi.org/10.1186/1477-7819-4-14
Journal volume & issue
Vol. 4, no. 1
p. 14

Abstract

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Abstract Background 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. Methods 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. Results 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. Conclusion 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(