Surgical experience with adenocarcinoma of the ampulla of Vater.
Between 1968 and 1982, 13 patients in this study had a pancreaticoduodenectomy (PD), one patient had a total pancreatectomy, two had an ampullectomy, and one patient had a choledochoduodenostomy for neoplasia of the ampulla of Vater. The operative mortality was zero, and the 5-year actuarial survival rate for the 16 resected patients was 52.6 per cent. From a review of the literature, the authors evaluated 1,894 PDs and 61 ampullectomies. The operative mortality rate was 14 per cent and 3 per cent, respectively. The 5-year survival rate was 21 per cent for PD and 23 per cent for ampullectomy. However, 187 patients with negative lymph nodes who underwent PD had a 5-year survival rate of 39 per cent. PD resection is fully warranted for ampullary tumors. Ampullectomy should be reserved only for high surgical risk patients.
D000230:Adenocarcinoma / Q000601:surgery*; D014670:Ampulla of Vater; D003138:Common Bile Duct Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D010180:Pancreatectomy / Q000401:mortality; D010185:Pancreatic Fistula / Q000209:etiology; D011183:Postoperative Complications / Q000209:etiology