Laparoscopic ampullectomy for an ampullarian adenoma


Lesions involving the ampulla of Vater are rare entities (0.1–0.2 %) with high malignant potential (90 %) [1]. As a treatment, the surgical procedure known as duodenopancreatectomy was the main option, whatever the tumor’s stage or nature. Yet with improvements of endoscopic diagnostic and therapeutic techniques, management of these lesions has been modified, enabling endoscopic removal of adenoma and adenocarcinoma-in situ. Thus, when endoscopic treatment is not possible, surgical ampullectomy is still an alternative option to duodenopancreatectomy [1, 2]. The continuous improvements in surgical techniques and instruments now allow the safe realization of laparoscopic ampullectomy, despite the few cases described in the literature [3, 4]. Here we present a surgical technique in a 52-year-old patient with an ampulloma. The ampulloma was discovered during a gastroscopy for abdominal pain. The endoscopic ultrasound with biopsy revealed a 15-mm adenoma with moderate-grade dysplasia. The thoracoabdominal CT scan was normal. The procedure was performed as shown. The tumor histology showed a R0 resection (5-mm surgical margin) of an adenoma with focal high-grade dysplasia. At 3-year follow-up, outcomes were unremarkable, without any complications.


  1. 1.

    Beger HG, Treitschke F, Gansauge F, Harada N, Hiki N, Mattfeldt T (1999) Tumor of the ampulla of Vater: experience with local or radical resection in 171 consecutively treated patients. Arch Surg 134(5):526–532

  2. 2.

    Sastre B, Ouaissi M, Chaix JB, Pirro N, Cosentino B, Sielezneff I (2006) Resection of the ampulla of Vater. J Chir (Paris) 143:246–250

  3. 3.

    Ahn KS, Han HS, Yoon YS, Cho JY, Khalikulov K (2010) Laparoscopic transduodenal ampullectomy for benign ampullary tumors. J Laparoendosc Adv Surg Tech 20(1):59–63

  4. 4.

    Rosen M, Zuccaro G, Brody F (2003) Laparoscopic resection of a periampullary villous adenoma. Surg Endosc 17(8):1322–1323

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No funding has been received for this work from any of the following organizations: National Institutes of Health (NIH); Wellcome Trust; Howard Hughes Medical Institute (HHMI); and other(s).

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Correspondence to Alban Zarzavadjian Le Bian.

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Borie, F., Zarzavadjian Le Bian, A. Laparoscopic ampullectomy for an ampullarian adenoma. Surg Endosc 27, 4385 (2013).

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  • Ampulla of Vater
  • Ampullectomy
  • Laparoscopy