Malignant Tumors of the Ampulla of Vater
About half the ampullary carcinomas cause jaundice early and are thus diagnosed at a resectable stage. Ampullectomy is acceptable for stage o-I tumors. Whipple’s operation is appropriate for patients with stage II, III and IV tumors showing pancreatic but not extrapancreatic infiltration. These patients should be devoid of any other significant comorbidity. Palliative endoscopic stenting of the bile duct alleviates symptoms associated with obstructive jaundice in patients with advanced cancer (stage IV/extrapancreatic infiltration, distant métastases) or inoperability. At present there is no indication for multimodal treatments (e.g., radiotherapy, chemotherapy, radio chemotherapy). The prognosis of ampullary carcinoma is better than that of pancreatic or cholangiocellular cancer. The single most important factor predicting survival is disease stage at the time of diagnosis.
KeywordsBile Duct Pancreatic Duct Familial Adenomatous Polyposis Obstructive Jaundice Biliary Tract Cancer
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