Good Outcome From Surgery for Ampullary Tumour

Abstract

Proximal pancreaticoduodenectomy, preferably a pylorus-preserving procedure, is safe and effective in the treatment of ampullary carcinoma, with low operative mortality and good long-term survival. Local resection is only recommended for small benign tumours and for patients who may be unfit for radical surgery.

Clinicopathologic Analysis of Ampullary Neoplasms in 450 Patients: Implications for Surgical Strategy and Long-Term Prognosis

“…Other published data have reported 5-year survival around 50%. 34,39,43 Compared with invasive adenocarcinoma of the pancreas which has a 5-year survival in the range of 20%, 42 ampullary adenocarcinoma has a much better overall survival following resection. The improved survival for ampullary adenocarcinoma may be related in part to the higher rate of resection of ampullary lesions.…”

Local resection of ampullary adenocarcinomas of the duodenum

“…Recent series report zero operative mortality using LR 18–21 . In patients with ampullary lesions treated by PD, operative mortality generally ranges from 3 to 5% in major centres 12,13,18,22,23 . The morbidity associated with LR is usually < 25% and includes pancreatitis and haemorrhage 11,19,24–28 .…”

“…[18][19][20][21] In patients with ampullary lesions treated by PD, operative mortality generally ranges from 3 to 5% in major centres. 12,13,18,22,23 The morbidity associated with LR is usually < 25% and includes pancreatitis and haemorrhage. 11,19,[24][25][26][27][28] Pancreaticoduodenal resection has a morbidity of 25-60%, with pancreatic fistula, haemorrhage and delayed gastric emptying being the most significant.…”

Tumor-related factors and patient’s age influence survival after resection for ampullary adenocarcinoma

“…4,19 The published data show 1-year survival after pancreatoduodenectomy for cancer of the papilla of Vater to be around 80%, 3-year survival around 60%-70%, and 5-year survival around 50%. 20,21 Moreover, in a recently published series with R0 resection in T1 patients, the 5-year survival was 100%. 22 It is obvious that R0 resection is mandatory to achieve adequate long-term results, as was shown by our results.…”