Review of the investigation and surgical management of resectable ampullary adenocarcinoma

Askew, James; Connor, Saxon

doi:10.1111/hpb.12038

Cited by 40 publications

(35 citation statements)

References 99 publications

(116 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In the present series, histopathology from endoscopic biopsies of the papilla was in exact agreement with post-papillectomy histopathology in only 48% of the cases, a finding consistent with previous observations [10,11]. Furthermore, our data also support previous reports that malignancies can be missed if one relies exclusively on endoscopic biopsies [12]. This indicates that endoscopic papillectomy should be performed with liberal indications in order to get a more precise histopathological evaluation before deciding on the optimal treatment for an individual patient.…”

Section: Discussionsupporting

confidence: 92%

“…Villous or tubulovillous adenomas of the ampulla of Vater are of particular interest since they may harbor an undetected adenocarcinoma that could become invasive if left untreated [6][7][8][9]. Before the development of endoscopic papillectomy, pancreaticoduodenectomy or transduodenal ampullectomy were the only curative options for these local tumors, surgical interventions that has significant post-operative morbidity [10][11][12]. In recent years, endoscopic papillectomy has been put forward as the preferred method for treating benign and maybe even low-grade malignant adenomatous lesions in the major duodenal papilla [13][14][15][16].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Endoscopic papillectomy andKRASexpression in the treatment of adenoma in the major duodenal papilla

Haraldsson

Swahn

Verbeke

et al. 2015

Scandinavian Journal of Gastroenterology

View full text Add to dashboard Cite

Endoscopic papillectomy is a valuable staging tool because of the limitations of endoscopic biopsy. Endoscopic papillectomy concomitantly offers a curative treatment for most patients with adenoma in the major duodenal papilla. Jaundice at presentation and large adenomas may indicate the presence of more advanced disease. Determination of mutated KRAS seems to be of limited value in predicting long-term outcome.

show abstract

Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Endoscopic papillectomy andKRASexpression in the treatment of adenoma in the major duodenal papilla

Haraldsson

Swahn

Verbeke

et al. 2015

Scandinavian Journal of Gastroenterology

View full text Add to dashboard Cite

show abstract

“…With this in mind, Figure 1 aimed to propose an algorithm to guide the decision-making for the preoperative assessment and for the treatment of ampullary neoplasms, primarily based on the evidence from the literature (3,7,8,12,15). This algorithm may be particularly pertinent to help gastroenterologists and hepatopancreatobiliary surgeons, to tailor their decision-making for the treatment of patients with noninvasive ampullary tumors.…”

Section: Discussionmentioning

confidence: 99%

“…Strikingly, no dedicated guidelines for the treatment of these tumors have been proposed so far. Although pancreaticoduodenectomy (PD) has been evidenced as the treatment of choice for invasive ampullary tumors (1,3), its high morbidity and mortality may not be justified for non-invasive tumors. (4)(5)(6).…”

Section: Introductionmentioning

confidence: 99%

Endoscopic and surgical ampullectomy for non-invasive ampullary tumors: Short-term outcomes

Dubois¹,

Labgaa²,

Dorta³

et al. 2016

BST

View full text Add to dashboard Cite

“…In periampullary tumors EUS is su perior to CT in evaluat ing T stage, re gional lymph node metastasis or major vascular invasion, therefore EUS is crucial for decid ing between endoscopic or surgical treatment [5,6,[28][29][30]. Also, EUS (Fig.…”

Section: Type Of Complicationmentioning

confidence: 99%

Surgical Treatment of Ampullary Adenocarcinoma – Single Center Experience and a Review of Literature

et al. 2018

View full text Add to dashboard Cite

SummaryBackground: Adenocarcinomas of ampulla of the Vater are relatively uncommon tumors of the gastrointestinal tract. In premalignant lesions endoscopic treatment predominate. Accord ing to some authors even early adenocarcinomas (limited to mucosa) can be solved endo scopically. In malignant lesions affect ing deeper layers (includ ing submucosa) surgical ther apy is the most important. The article summarises the current view for a surgical treatment of ampullary adenocarcinomas and presents results concern ing our group of patients. Materials and Methods: In 2012-2016 a total number of 17 patients underwent resection for a tumor of ampulla of the Vater. Patients underwent standard staging, were presented before a mul tidisciplinary committee and referred to a surgical treatment. The main measured parameters were the type of surgical procedure, 30day morbidity and mortality, histopathologic result and subsequent oncologic treatment. The Leeds Pathology Protocol was used to evaluate the specimens after pancreaticoduodenectomy (PD). Results: PD (n = 9) was a more often perfor med procedure than the transduodenal surgical ampullectomy (TSA) (n = 8). TSA predomina ted in polymorbid patients. Histological results (n = 17) established adenoma with highgrade dysplasia in 4 patients, the dia gnosis of adenocarcinoma was set in 13 patients. Eight patients underwent adjuvant oncologic ther apy (2 had adjuvant chemother apy, 6 had combination of chemoradiother apy). Conclusion: Premalignant neoplasias of ampulla of the Vater can be mostly solved by endoscopy. If endoscopic resection is not possible surgical ther apy is indica ted. PD is preferred procedure in the dia gnosis of adenocarcinoma. In highrisk and polymorbid patients, with no suspicion for a metastatic lymph nodes, TSA can be considered. Endoscopic ultrasonography is the imag ing modality of choice for local stag ing of ampulla of the Vater and has important role in decid ing between endoscopic, local surgical excision (TSA) or radi cal resection (PD). Our results confirmed rightfulness to perform TSA especially in elderly or polymorbid patients, where in histopathologic specimens evaluation in TSA procedures early T stage and more favorable grad ing predominated.

show abstract

Review of the investigation and surgical management of resectable ampullary adenocarcinoma

Abstract: Optimal staging should be used to distinguish between ampullary adenoma and adenocarcinoma. Pancreaticoduodenectomy remains the treatment of choice for all ampullary adenocarcinomas.

Cited by 40 publications

References 99 publications

Endoscopic papillectomy andKRASexpression in the treatment of adenoma in the major duodenal papilla

Endoscopic papillectomy andKRASexpression in the treatment of adenoma in the major duodenal papilla

Endoscopic and surgical ampullectomy for non-invasive ampullary tumors: Short-term outcomes

Surgical Treatment of Ampullary Adenocarcinoma – Single Center Experience and a Review of Literature

Contact Info

Product

Resources

About