Surgical Ampullectomy with Complete Resection of the Common Bile Duct: a New Procedure for Radical Resection of Non-invasive Ampulloma with Biliary Extension

Overview

Journal J Gastrointest Surg

Specialty Gastroenterology

Date 2017 Jun 1

PMID 28560704

Citations 4

Authors

Alain Sauvanet

Safi Dokmak

Jerome Cros

Dominique Cazals-Hatem

Philippe Ponsot

Maxime Palazzo

Affiliations

Soon will be listed here.

Abstract

Extension of ampulloma into the lower common bile duct (CBD) is observed in up to 30% of cases. This biliary extension can prevent complete tumor resection thus is considered as a contraindication for endoscopic and even surgical ampullectomy. For ampullomas associated with a prolonged biliary extension, a pancreaticoduodenectomy is associated with a high morbidity and can be considered as an overtreatment for a benign neoplasm. The present study describes a new surgical approach including ampullectomy with complete resection of the intrapancreatic CBD and restoration of both biliary and pancreatic flow by two separate anastomoses. This procedure was performed in seven patients for a non-invasive ampulloma with a 25- to 70-mm CBD involvement. No patients died and three developed postoperative complications. Resection was R0 in all patients but one. With a 24-month median follow-up (range = 3-84), no patients developed pancreatic insufficiency or tumor recurrence.

Citing Articles

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Parenchymal Sparing Resection: Options in Duodenal and Pancreatic Surgery.

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Combined excision and ablation of ampullary tumors with biliary or pancreatic intraductal extension is effective even in malignant neoplasms.

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Transduodenal ampullectomy for ampullary tumors - single center experience of consecutive 26 patients.

Hong S, Song K, Lee Y, Park K, Kim S, Hwang D Ann Surg Treat Res. 2018; 95(1):22-28.

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