title: Transduodenal excision of giant tumour of the ampulla of Vater: a case report.
abstract: Carcinoma of the papilla is a rare cancer of the digestive tract; 5% of all gastrointestinal tract malignant neoplasms are periampullary. The authors report and discuss the case of one of their patients aged 79 years suffering from a tumour of the papilla. The case was characterized by the large size of the neoplasm (5.5 cm in diameter) and by the poor clinical conditions of the patient, who was suffering from Parkinson's disease and was at high operative risk. The surgical strategy chosen involved transduodenal excision of the tumour with duodenum-bile duct anastomosis and internal duodenum-Wirsung duct anastomosis. The authors first examine the hypothesis that carcinoma of the papilla may represent the evolution of an adenomatous lesion and then go on to assess the therapeutic strategy adopted in the treatment of these neoplasms: in patients at high operative risk a transduodenal excision of the tumour with duodenum-bile duct anastomosis and internal duodenum-Wirsung duct anastomosis may be a valid alternative to the conventional Whipple procedure.
authors.affiliation: Division of General Surgery, Department of Surgical Sciences, University of Rome La Sapienza, Rome.
authors.forename: Antonio
authors.initials: A
authors.lastname: Catania
authors.forename: Laura
authors.initials: L
authors.lastname: Falvo
authors.forename: Vito
authors.initials: V
authors.lastname: D'Andrea
authors.forename: Salvatore
authors.initials: S
authors.lastname: Sorrenti
authors.forename: Arvin
authors.initials: A
authors.lastname: Dibra
authors.forename: Nicola
authors.initials: N
authors.lastname: Foti
authors.forename: Alessia
authors.initials: A
authors.lastname: Biancafarina
authors.forename: Benedetta
authors.initials: B
authors.lastname: Vanni
authors.forename: Enrico
authors.initials: E
authors.lastname: De Antoni
mesh_terms: D000368:Aged; D014670:Ampulla of Vater / Q000601:surgery*; D001662:Biliary Tract Surgical Procedures / Q000379:methods; D003138:Common Bile Duct Neoplasms / Q000601:surgery*; D006801:Humans; D008297:Male