Evaluation and management of periampullary tumors

Abstract

Periampullary cancers make up 5% of all gastrointestinal cancers. The complexity of the periampullary anatomy makes determination of the origin of some of these tumors difficult. However, advances in imaging have helped with diagnosis as well as defining the extent of the lesion and its potential resectability. For many of these tumors, surgery is the recommended treatment. However, endoscopic removal is being extended to different lesions with encouraging preliminary results. Improvements in overall prognosis for periampullary tumors will be limited until diagnosis can be established earlier in the course of the disease and adjuvant therapies become more effective.

Immunocytochemical Assessment of p53 Protein to Detect Malignancy in Increased Cell-Yield Brush Cytology from the Biliopancreatic Tree

“…15/24 patients (62.5%) had a neoplasm subsequently confirmed by biopsy or postoperative histological assessment (Table 1). These neoplasms consisted of ampullary carcinomas (4), pancreatic carcinomas (9), and cholangiocarcinomas (2). No endocrine tumors were detected.…”

“…Many ampullary adenomas (up to 80%) are common benign ampullary tumors; however, they can range from mild dysplasia to high-grade dysplasia to invasive carcinoma [1]. These neoplasms may be found in the setting of familial polyposis syndromes or sporadically, usually manifested by vague abdominal pain, liver enzyme elevation, jaundice, recurrent pancreatitis, or with uncommon symptoms such as gastrointestinal bleeding or duodenal obstruction [2]. Endoscopic retrograde cholangiopancreatography (ERCP) with biopsy is commonly used to visualize these tumors directly and to evaluate their histologic characteristics [3].…”

Periampüller bölge tümörlerinin tanısında papil biyopsisi ve endoskopik görünümün rolü: tek merkez deneyimi

“…Epitelyal malignensilerin yaklaşık %1'ni ve tüm gastrointestinal malignensilerinin de yaklaşık %5'ini oluşturmaktadır. Anatomik yerleşim yeri özelliklerinden dolayı erken belirti verdiklerinden dolayı pankreas başı kanserinin aksine prognozu daha iyidir ve tanı anında hastaların büyük çoğunluğunda tümör cerrahi olarak çıkarılabilmektedir (14). Ampulla vateri tümörü dahil PBT'inde standart pankreatikoduodenektomi tedavi şekli olarak kabul edilmekle beraber günümüzde pilor koruyucu pankreatikoduodenektomi genel prosedür haline gelmeye başlamıştır (15).…”

Complicaciones post-pancreatoduodenectomía de tumores periampulares en una unidad de cirugía hepatopancreatobiliar

“…Los tumores periampulares (TPA) se definen como lesiones ubicadas en un radio de 2 cm alrededor de la ampolla de váter 1,2 , es una región susceptible de malignidad por ser un área de transición epitelial que se irrita constantemente, tanto mecánica como químicamente 1,3 , con reportes de lesiones menores a 1cm en 17% y menores a 4cm de diámetro en 75% 2 . Los tumores periampulares (TPA) constan de 4 tipos de neoplasias con una alta tasa de malignidad que pueden originarse en páncreas, ampolla de Vater, conducto biliar común distal o duodeno 4 , cada una de ellas con un pronóstico de vida variable que puede ser del 15%, 27%, 39%, 59% respectivamente, siendo el carcinoma de páncreas el de menor índice de supervivencia a 5 años 1,5 .…”

“…Los tumores periampulares (TPA) constan de 4 tipos de neoplasias con una alta tasa de malignidad que pueden originarse en páncreas, ampolla de Vater, conducto biliar común distal o duodeno 4 , cada una de ellas con un pronóstico de vida variable que puede ser del 15%, 27%, 39%, 59% respectivamente, siendo el carcinoma de páncreas el de menor índice de supervivencia a 5 años 1,5 . Este grupo de neoplasias representa entre el 0,2%-5% 2,6,7 de todos los cánceres gastrointestinales, con predominio en el sexo masculino.…”