title: Local excision as a treatment for tumors of ampulla of Vater.
abstract: BACKGROUND
  Although local excision (ampullectomy) was first described by Halsted in 1899, its adequacy as an alternative surgical treatment for the ampullary tumors is still a matter of debate. The aim of this study was to evaluate the results of ampullectomy as a curative treatment for benign and malignant tumors arising from the ampulla, in a 14-year single-institution experience.
  
  
  METHODS
  From 1990 to 2004, a total of 20 patients of adenocarcinoma (12) or adenoma (8) of the ampulla of Vater underwent local excision. Clinical data were collected and morbidity, mortality, as well as long-term survival were evaluated. The usefulness of several pre or intraoperative diagnostic methods was also recorded. Median follow-up was 85 (range 6-180) months.
  
  
  RESULTS
  The combination of endoscopic preoperative biopsies and intraoperative frozen section examination adequately diagnosed ampullary tumors in all cases. The postoperative morbidity and mortality were 0%, whereas the 3 and 5-year survival rates for the patients with adenocarcinoma was 75 % and 33.3 % respectively. All the patients with adenoma are still alive without any sign of recurrence.
  
  
  CONCLUSIONS
  In our series, local excision was a safe option, associated with satisfactory long-term survival rates in patients with benign lesions and in those with small(<2 cm), pT1, well differentiated ampullary tumours without nodal involvement.
authors.affiliation: 4th Surgical Department, Aristotle University of Thessaloniki, G. Papanikolaou' General Hospital, Exohi, Thessaloniki 57010, Greece. haral@med.auth.gr
authors.forename: Haralampos
authors.initials: H
authors.lastname: Demetriades
authors.forename: Emmanouil
authors.initials: E
authors.lastname: Zacharakis
authors.forename: Ioanna
authors.initials: I
authors.lastname: Kirou
authors.forename: Manousos-Georgios
authors.initials: MG
authors.lastname: Pramateftakis
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Sapidis
authors.forename: Ioannis
authors.initials: I
authors.lastname: Kanellos
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Betsis