[Value of surgical ampullectomy in the management of benign ampullary tumors].
OBJECTIVE
To report the results of transduodenal excision (TDE) for tumors of the ampulla of Vater.


METHODS
From 1998 to 2003, 10 patients underwent a transduodenal excision for presumed benign tumors of the ampulla of Vater. After resection, frozen sections were performed to ensure negative margins.


RESULTS
There was no operative mortality. A postoperative pancreatitis occurred in one patient. For nine patients the postoperative course was uneventful. The mean duration of hospital stay was 18 +/-11 days. The final pathology showed adenoma in 8 patients, an adenocarcinoma in one patient and inflammatory lesions in other one. With a mean follow-up of 20 months, endoscopy did not show any recurrence in patients with benign lesion. Patient with an invasive cancer developed recurrence.


CONCLUSIONS
Transduodenal excision is safe and effective treatment for benign ampullary tumors. TDE should be the operation of choice for patients with histologically-proven benign ampulloma, staged as uT1 by endoscopic ultrasound. This approach could reduce the rate of pancreaticaduodenoctomy performed for benign ampullomas.
Sa Cunha
A
A
Service de chirurgie digestive et endocrinienne, hôpital Haut-l'Evêque, avenue de Magellan, 33604 Pessac, France.
Larroudé
D
D
Laurent
C
C
Rault
A
A
Collet
D
D
Masson
B
B
D000368:Aged; D014670:Ampulla of Vater / Q000601:surgery*; D003138:Common Bile Duct Neoplasms / Q000601:surgery*; D004386:Duodenum / Q000601:surgery; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000209:etiology; D011183:Postoperative Complications; D012189:Retrospective Studies; D016896:Treatment Outcome