Tumours and pseudotumours of the region of the ampulla of Vater: an endoscopic, clinical and pathological study. Academic Article uri icon

Overview

abstract

  • From a large series of patients referred for endoscopic retrograde cholangiopancreatography to one endoscopist, 49 patients had the duodenoscopic appearance of a periampullary tumour. Thirty eight of these lesions were neoplastic, but the remaining 11 patients had inflammatory non-neoplastic lesions (pseudotumours). These could not be distinguished from the neoplasms on endoscopic appearances. The cholangiopancreatograms were similar except that the diameter of the pancreatic duct tended to be higher in the tumour group and gall stones were present significantly more often in the patients with pseudotumour. Endoscopic biopsy correctly diagnosed 28 of 34 ampullary carcinomas. Two of the 11 pseudotumour patients were subjected to surgical excision biopsy because of suspicious histological features of endoscopic biopsy. In the neoplastic group 19 patients underwent Whipple's procedure, seven surgical bypass, seven endoscopic sphincterotomy only and five died without successful biliary drainage. The overall one year survival was 44.7%. By contrast, the patients with pseudotumours were clinically well at a median follow up 24 months (range 12-41 months), after endoscopic sphincterotomy except for one 89 year old patient who died 22 months later from unrelated causes.

publication date

  • October 1, 1986

Research

keywords

  • Ampulla of Vater
  • Common Bile Duct Neoplasms

Identity

PubMed Central ID

  • PMC1433871

Scopus Document Identifier

  • 0022543690

Digital Object Identifier (DOI)

  • 10.1136/gut.27.10.1186

PubMed ID

  • 3781332

Additional Document Info

volume

  • 27

issue

  • 10