Abstract. KCAM, Eduardo; TAVARA, Franklin; MILLA, Ricardo and GONZALEZ, Steffi. Ampulloma treatment with Whipple surgery. First case report in the. findings by associating the ampuloma of pancreatobiliar origin with the infiltrative pattern, and .. y tratamiento del cáncer de páncreas. Med Clin (Barc). ampuloma de vater pdf. Quote. Postby Just» Tue Aug 28, am. Looking for ampuloma de vater pdf. Will be grateful for any help! Top.

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Patients with a prior history of another neoplastic disease during the 5 previous years were excluded, as were those with difficult endoscopic access to the papilla e.

Both techniques are less helpful in accurately determining the presence or absence of lymph node metastases 8,9.

ampuloma de vater pdf

Endoscopy in the management of pancreatic cancer. Early mortality was similar in both ampulomma, in 6 cases due to the advanced state of the neoplastic disease, and in another 4 following complications in the biliary drainage 2 after endoscopic drainage and 2 after surgical drainage. Regarding surgical treatment, the results from our series and from other trials do not currently allow recommending routine palliative resection, nor do they justify the operation as a reductive process of tumor mass.

Endoscopic snare resection does not allow a wide resectional margin on the pancreatic side, and the possibilities of local recurrence are higher, which restricts its indication as a palliative treatment for patients unfit for surgery or rejecting it General Surgery Department “A”.

Pancreatic involvement will lead to PD with lymphadenectomy, because of lymphatic spread after pancreatic dissemination, as it happened in two of our patients.

With these results it may be stated that the quality of life provided by both palliative treatment procedures is similar in patients with malignant obstruction of the biliary duct. As stated previously, the purpose of applying palliative treatment to a patient with malignant obstructive jaundice is not only to increase long-term survival, but also to maintain good quality of life during the period of tratamiengo between the diagnosis of the disease and the patient’s death.


Boston Med Surg ; InAbraham Vater described a new anatomic entity that today is called the Vater’s ampulla 1. Survival, disease-free survival and comfort index ratio were greater in the group who received resection surgery than in the patients undergoing bypass surgery Table Traramientowith no significant differences in the rest of the prognostic variables.

Endoscopy and cholangioresonance, performed before sphincterotomy and endoprosthesis insertion to minimize interpretation mistakes, allow lesion staging, overall and regarding depth of penetration into the duodenal wall and the pancreas. However, overstaging due to submucosal edema from associated pancreatitis has been reported in as much as one third of lesions. All patients underwent ampullectomy; the tumor was near the resection margin in 3 of 6 adenocarcinomas, and surgery was completed by means of PD in two cases; the third patient was a poor candidate for this type of surgery; therefore, the operation was not completed, and the patient died 13 months later.

We found that the result for these variables was better after surgery, though not significantly.

However, further studies are required including greater numbers of patients in order to obtain more conclusive results. European Association for Gastroenterology Postgraduate course. Case 7 refused to go on with PD if there was an indication for that procedure; so, although the resection margin was lower than 1 cm, we performed only an ampullectomy.

An appropriate selection of those patients in whom local resection would be safe and effective would allow this suitable treatment, depending on the kind of tumor. Patient survival and quality of life were analyzed, with good quality of life defined as absence of jaundice, pruritus and cholangitis after initial treatment. Locoregional lymph node dissection was performed only after PD. Only patients with a malignant histological diagnosis or cholangiography and at least one other compatible image technique ultrasound, CAT or cholangio-MRIand who followed a clinical evolution of malignant disease, were included.

Acta Gastroenterol Belg ; Ampulloma treatment with Whipple surgery.

ampuloma de vater pdf

The presence of these symptoms led us to perform hepatic function tests and an abdominal ultrasonography. Because of this, some authors advocate for both local lymphadenectomy and trtaamiento in order to improve prognosis 18, Acta Chir Scand ; The main causes of malignant obstruction of the main biliary duct are ampullary carcinoma, adenocarcinoma of the pancreatic head, cholangiocarcinoma and vesicular cancer 1.


In our series, patients who received ampulomw biliary drainage stayed in hospital for It analysed survival, quality of life and comfort index of jaundiced patients. Ampulla of Vater ; Ampullary adenocarcinoma ; Jaundice ; Whipple disease.

Management of malignant obstructive jaundice at the Middlesex hospital.

Am J Gastroenterol ; On the one hand, patient selection type for each treatment group must be taken into account. However, they would be able to select patients who may be optimally managed by endoscopic resection. In the series by Lillamoe et al.

From the s onwards, percutaneous drainage began to be used, though the morbidity linked to the technique led to its being relegated in favor of endoscopic drainage 7.

In our series, fratamiento quality of life is defined as hratamiento of jaundice, pruritus and cholangitis; disease-free survival after the operation was analyzed and the comfort index was calculated, both tratamiengo measures which express, simply and objectively, the quality of life of these patients. Survival in both studies was greater after palliative resection than after bypass surgery. CEA was always normal, and the extension tratamiengo by CT was normal as well.

The Vater’s ampulla has a distinct pattern of lymphatic drainage, and in contrast to pancreatic tumors, ampullary tumors spread into the nearby retroduodenal nodes, even in non-advanced cases. Local resection of tumors of the ampulla of Vater. However, in our group of patients, surgery offers increased survival and disease-free survival, despite not influencing the comfort index. Thus, age, number of leukocytes, hemoglobinemia, serum levels of creatinine and alkaline phosphotase are greater in the first group than in the second group.