Transduodenal excision of benign adenoma of the papilla of Vater.
OBJECTIVE
To evaluate methods of diagnosis and treatment of benign adenoma of the papilla of Vater.


METHODS
Retrospective study.


METHODS
University hospital, Finland.


METHODS
Five patients who had transduodenal excision of adenomas of the papilla of Vater from 1988-1993.


METHODS
Symptoms, preoperative staging with side-viewing duodenoscopy and endoscopic retrograde cholangiopancreatography, histological appearance of operative frozen section, postoperative complications, and duodenoscopic follow up.


RESULTS
Only the patients with tumours less than 3 cm and strictures of the distal bile or pancreatic duct of less than 1.5 cm were selected for transduodenal excision. Both examination of operative frozen sections and final histological examination confirmed benign adenoma in each patient. Four of the patients recovered with no complications, but one patient developed bronchopneumonia. The preoperative symptoms (bleeding, jaundice, pancreatitis, pain) resolved in all patients. During the follow up (median 18 months) none of the patients developed recurrent disease.


CONCLUSIONS
This experience supports our policy of transduodenal excision of benign adenoma of the papilla of Vater for carefully selected patients.
Sand
J A
JA
Department of Surgery, Tampere University Hospital, Finland.
Nordback
I H
IH
D000236:Adenoma / Q000473:pathology / Q000601:surgery*; D018253:Adenoma, Villous / Q000473:pathology / Q000601:surgery; D000368:Aged; D014670:Ampulla of Vater / Q000473:pathology / Q000601:surgery*; D002760:Cholangiopancreatography, Endoscopic Retrograde; D003138:Common Bile Duct Neoplasms / Q000473:pathology / Q000601:surgery*; D004384:Duodenoscopy; D004386:Duodenum / Q000601:surgery; D004564:Electrocoagulation; D005260:Female; D005500:Follow-Up Studies; D005629:Frozen Sections; D006801:Humans; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000209:etiology; D011183:Postoperative Complications; D012189:Retrospective Studies