title: Extended excision of the ampulla of Vater--a new operative technique for elderly patients.
abstract: This report describes a 72-year-old female patient treated by extended excision of recurrent ampullary carcinoma. The procedure comprised pylorus-preserving resection of the descending segment of the duodenum, and excision of a large portion of the pancreatic head using an ultrasonic surgical dissector. Restoration of food transit, pancreatico-jejunal and choledocho-jejunal anastomosis by a Roux-en-Y reconstruction was readily accomplished. The operation, which has the advantage of being more radical and accurate than the standard excision of the ampulla of Vater, and less time-consuming and mutilating than the Whipple procedure, may be indicated in elderly patients with ampullary carcinoma.
authors.affiliation: Department of Gastroenterologic Surgery, University Medical Centre, Ljubljana, Slovenia.
authors.forename: E
authors.initials: E
authors.lastname: Gadzijev
authors.forename: V
authors.initials: V
authors.lastname: Pegan
mesh_terms: D000367:Age Factors; D000368:Aged; D014670:Ampulla of Vater / Q000601:surgery*; D001662:Biliary Tract Surgical Procedures / Q000379:methods; D003138:Common Bile Duct Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000601:surgery*