[Carcinoma of the papilla: bypass, Whipple, or papillectomy?]

The records of 41 patients who had carcinoma of the ampulla of Vater in the period 1952-1973, are reviewed. Palliative operations were disappointing in 16 patients since they resulted in an average survival of only a few months. The most impressive results were obtained with the one-stage Whipple procedure and, in selected cases, by simple papillectomy with survival of up to 6 years. However, not every surgeon is able to deal competently with the difficult problems of malignant jaundice. Special technical and tactical skill is a precondition and systematic diagnostic evaluation as well as modern intensive care are necessary for good results. The ampullomas have the best prognosis in the group of peripapillary tumors.