title: Unusual presentation of obstructive jaundice.
abstract: Carcinoid tumors of the ampulla of Vater grow slowly and have an excellent prognosis after complete resection of local disease. Histopathological diagnosis is definitive, and the Whipple's procedure is performed as a standard at the present time, although more novel minimally-invasive techniques may be highly useful for selected patients. While tumor size is not a reliable marker of tumor aggression, it is nonetheless related to lymphatic invasion, hence an accurate diagnosis is important if the patient is to be offered the best option available for the treatment of their disease. Endoscopic ultrasound (EUS) is the technique of choice for presurgical assessment and endocopic excision, as it may rule out vascular and nodal involvement, and establish whether submucosal invasion is present, which precludes endoscopic resection. Local resection has been shown to obtain similar results as compared to CDP in terms of overall survival in patients with small periampullary NETs, with the advantage of significantly lower morbidity in selected cases.
authors.affiliation: Cirugia General, SAS - Hospital Virgen Macarena, España.
authors.forename: Alejandra
authors.initials: A
authors.lastname: Gordillo Hernández
authors.affiliation: Hospital Virgen Macarena, ,.
authors.forename: Ángel
authors.initials: Á
authors.lastname: Nogales Muñoz
authors.affiliation: Hospital virgen macarena, ,.
authors.forename: Fernando
authors.initials: F
authors.lastname: Oliva Mompeán
mesh_terms: D002760:Cholangiopancreatography, Endoscopic Retrograde; D005260:Female; D006801:Humans; D041781:Jaundice, Obstructive / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D016577:Pancreaticoduodenectomy; D014057:Tomography, X-Ray Computed