title: Tumors of the ampulla of Vater.
abstract: Ampullary tumors are relatively rare, but the occurrence of biliary obstruction early in the disease course facilitates diagnosis. With technologic advances, methods of diagnosis, treatment, and management of ampullary tumors are constantly evolving. However, despite rapid improvements in these areas, preoperative differentiation between adenomas and adenocarcinomas remains difficult. Forcep biopsy specimens can accurately detect the presence or absence of adenomatous changes, but they have a high false-negative rate for adenocarcinoma. Whereas it is generally agreed that all ampullary tumors should be removed or resected, patient selection for the various treatments, including pancreatoduodenectomy, local resection, and endoscopic treatment, remains controversial. Stage of disease, patient characteristics (ie, age and comorbid conditions), and local availability of expertise determine treatment options.
authors.affiliation: Medical College of Wisconsin, Froedtert Memorial Lutheran Hospital, 9200 West Wisconsin Avenue, Milwaukee, WI 53226, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Jean
authors.forename: Kulwinder
authors.initials: K
authors.lastname: Dua
mesh_terms: D014670:Ampulla of Vater; D002779:Cholestasis / Q000209:etiology; D003138:Common Bile Duct Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery*; D019160:Endosonography; D006801:Humans; D016577:Pancreaticoduodenectomy