Review of the investigation and surgical management of resectable ampullary adenocarcinoma.

摘要: Abstract Background Ampullary adenocarcinoma is considered to have a better prognosis than either pancreatic or bile duct adenocarcinoma. Pancreaticoduodenectomy associated with significant mortality and morbidity. Some recent publications advocated the use of endoscopic papillectomy for treatment early ampullary This article reviews investigations surgical options tumours. Methods A systematic review English-language articles was carried out using an electronic search Ovid MEDLINE (from 1996 onwards), PubMed Cochrane Database Systematic Reviews databases identify studies related investigation management Results Distinguishing between adenoma challenging given inaccuracy biopsy, which high false negative rates 25–50% been reported. Endoscopic ultrasound most accurate method local staging lesions, but distinguishing T1 T2 adenocarcinomas difficult. Lymph node metastasis occurs in disease process; it lowest tumours, risk still at 8–45%. Case reports successful resection transduodenal ampullectomy published, their duration follow-up limited. Conclusions Optimal should be used distinguish remains choice all adenocarcinomas.