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[Long term outcome following 26 surgical ampullectomies]
M Ouaïssi1, I Sielezneff, A Alves
1Service de chirurgie digestive et générale, hôpital Sainte-Marguerite, 270, boulevard Sainte-Marguerite 13009 Marseille, France. ouaissi_mehdi@hotmail.com
Annales De Chirurgie
|April 18, 2006
Summary
Surgical ampullectomy is a safe and effective alternative to pancreaticoduodenectomy for benign or non-invasive ampullary lesions. This procedure offers good long-term survival with low morbidity, even in select familial adenomatous polyposis cases.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Hepatobiliary Surgery
Context:
- Pancreaticoduodenectomy (PD) is the standard for ampullary tumors but carries significant risks.
- Ampullectomy presents a less invasive option for benign or selected high-risk ampullary lesions.
- Evaluating ampullectomy outcomes is crucial for refining treatment strategies.
Purpose:
- To report the early and long-term results of surgical ampullectomy for presumed benign ampullary lesions.
- To assess the safety, efficacy, and recurrence rates of ampullectomy.
- To determine the suitability of ampullectomy in specific patient groups, including those with familial adenomatous polyposis (FAP).
Summary:
- Twenty-six patients underwent surgical ampullectomy between 1981 and 2004, with 8 having FAP.
- Pathology confirmed 15 adenomas, 4 in situ adenocarcinomas, 2 endocrine tumors, and 5 other benign lesions.
- No mortality occurred; morbidity was 8%. Mean follow-up was 86 months, with 5-year survival at 92% and 4 local recurrences (none in FAP patients).
Impact:
- Ampullectomy demonstrates a favorable safety profile with no operative mortality and low morbidity.
- The procedure offers excellent long-term survival rates, comparable to more radical surgeries for selected lesions.
- Ampullectomy is a viable alternative to PD for benign or non-invasive ampullary neoplasms, including selected FAP cases.
