Transduodenal Ampullectomy for the Treatment of Early-Stage Ampulla of Vater Cancer

Background Transduodenal ampullectomy (TDA) is a less invasive procedure than pancreaticoduodenectomy (PD). However, the outcomes of TDA and PD have been compared rarely in early ampullary cancer. Methods From September 1994 to June 2013, the patients who underwent curative surgery for Tis or T1 amp...

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Bibliographic Details
Published in:World journal of surgery 2016-04, Vol.40 (4), p.967-973
Main Authors: Lee, Huisong, Park, Jin Young, Kwon, Wooil, Heo, Jin Seok, Choi, Dong Wook, Choi, Seong Ho
Format: Article
Language:English
Subjects:
Abdominal Surgery
Adult
Aged
Aged, 80 and over
Ampulla of Vater - surgery
Ampullary Cancer
Benign Neoplasm
Cardiac Surgery
Common Bile Duct Neoplasms - diagnosis
Common Bile Duct Neoplasms - mortality
Common Bile Duct Neoplasms - surgery
Female
General Surgery
High Local Recurrence Rate
Humans
Kaplan-Meier Estimate
Male
Medicine
Medicine & Public Health
Middle Aged
Neoplasm Staging
Original Scientific Report
Pancreatic Fistula
Pancreaticoduodenectomy - methods
Positive Resection Margin
Republic of Korea - epidemiology
Retrospective Studies
Surgery
Survival Rate - trends
Thoracic Surgery
Time Factors
Treatment Outcome
Vascular Surgery
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Summary:Background Transduodenal ampullectomy (TDA) is a less invasive procedure than pancreaticoduodenectomy (PD). However, the outcomes of TDA and PD have been compared rarely in early ampullary cancer. Methods From September 1994 to June 2013, the patients who underwent curative surgery for Tis or T1 ampulla of Vater neoplasm were identified. The patients were divided into two groups according to the types of surgery; TDA group and PD group. The patient characteristics and survival outcomes were retrospectively investigated between the two groups. Results Total 137 patients were included in this study. The 18 patients underwent TDA and 119 patients underwent PD for Tis or T1 ampullary cancer. There was no lymph node metastasis in the patients with Tis tumor although 10 of 104 patients had lymph node metastasis in T1 cancer. After a median follow-up of 50 months (range, 6–148), there were no recurrence after TDA for Tis tumor. However, the TDA was associated with higher local recurrence rate than PD in the patients with T1 ampullary cancer on Kaplan–Meier survival analysis ( p  = 0.007). Conclusion The TDA is feasible treatment for Tis ampulla of Vater neoplasm. However, TDA is unsuitable for the treatment of T1 ampulla of Vater cancer.
ISSN:0364-2313
1432-2323
DOI:10.1007/s00268-015-3316-x