Research

Local excision as a treatment for tumors of ampulla of Vater

Haralampos Demetriades , Emmanouil Zacharakis , Ioanna Kirou , Manousos-Georgios Pramateftakis , Nikolaos Sapidis , Ioannis Kanellos and Dimitrios Betsis

4^th Surgical Department. Aristotle University of Thessaloniki, 'G. Papanikolaou' General Hospital, Exohi, Thessaloniki 57010, Greece

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World Journal of Surgical Oncology 2006, 4:14doi:10.1186/1477-7819-4-14

Published:	8 March 2006

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.

Conclusion

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.