Our Experience With Transduodenal Surgical Ampullectomy

Area of Science:

• Gastroenterology and Surgical Oncology

Background:

• Ampullary tumors (AT) are rare gastrointestinal neoplasms, comprising approximately 0.5% of all GI tumors.
• Current treatment options for AT include endoscopic papillectomy (EP), surgical transduodenal ampullectomy (TDA), and partial pancreatoduodenectomy (PD).

Observation:

• This report details two cases of Arabic men diagnosed with AT presenting with epigastric pain.
• Transduodenal ampullectomy (TDA) was performed on both patients shortly after diagnosis.

Findings:

• One patient required a partial gastrectomy on postoperative day 11.
• The second patient underwent endoscopic pyloric re-opening on postoperative day 11 to address gastric outlet obstruction.
• Both patients achieved oral tolerance and were discharged following TDA and subsequent interventions.

Implications:

• The findings suggest TDA is a viable surgical approach for ampullary tumors, though complications like gastric outlet obstruction can occur.
• Further randomized controlled trials are essential to evaluate the long-term efficacy, safety, and efficiency of TDA compared to other treatment modalities.