Ampullary cancer with pancreas divisum treated by endoscopic partial papillectomy: a case report

We herein report a case of ampullary cancer associated with pancreas divisum. Duodenoscopy revealed a tumor at the ampulla of Vater with a normal ampullary orifice. Intraductal ultrasonography showed a hypoechoic mass limited to the ampulla of Vater. ERCP showed an arborizing ventral pancreatic duct without connection to the dorsal duct. Endoscopic snare resection of the tumor was performed following biliary stenting. Histological examination revealed well-differentiated tubular adenocarcinoma limited to the ampulla of Vater. Endoscopic papillectomy with the assistance of a biliary stent is useful in cases of ampullary neoplasm with a normal ampullary orifice in order to avoid ductal injury.