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Transduodenal ampullectomy for ampullary tumor
Yun Kyung Jung1, Seung Sam Paik2, Dongho Choi1
1Department of Surgery, College of Medicine, Hanyang University, Seoul, Republic of Korea.
Asian Journal of Surgery
|January 24, 2021
Summary
Transduodenal ampullectomy (TDA) offers a viable surgical option for ampullary tumors, especially when endoscopic ampullectomy or pancreaticoduodenectomy is not feasible. TDA demonstrated no recurrence in early-stage ampullary cancer patients.
Area of Science:
- Gastroenterology
- Surgical Oncology
Background:
- Transduodenal ampullectomy (TDA) is a local excision technique for ampullary tumors, though not widely adopted.
- TDA is emerging as an alternative for patients unable to undergo endoscopic ampullectomy (EA) or pancreaticoduodenectomy (PD).
Purpose of the Study:
- To evaluate the surgical outcomes of Transduodenal ampullectomy (TDA).
- To assess the clinicopathological significance of pathologic findings in TDA.
Main Methods:
- Retrospective review of 31 patients with ampullary tumors who underwent TDA between March 2004 and December 2019.
- Analysis included patient records, surgical outcomes, and pathological findings.
Main Results:
- 19 of 31 patients had malignancy; 12 had benign tumors.
- 50% of malignancy cases were missed in preoperative biopsies.
- No recurrence was observed in 15 patients with malignancy who underwent TDA alone (mean follow-up: 51.1 months).
Conclusions:
- TDA is a treatment option for benign ampullary tumors in patients unsuitable for EA.
- TDA may be considered for select early-stage (Tis, T1) ampullary cancer patients.
- Further research is needed to establish consensus on TDA indications for ampullary tumors.
