Advanced periampullary carcinoma: endoscopic palliation by sphincterotomy

We have described a 50-year-old woman with periampullary carcinoma with extensive infiltration of the duodenal wall arising from advanced tumor of the pancreatic head. Endoscopic sphincterotomy induced complete relief from jaundice and pruritus before definitive surgical therapy was done. This procedure should not be restricted to small tumors confined to the ampulla itself, since it may also be of palliative or preoperative value in certain patients with advanced cancer of the pancreatic head.