Journal article
Contemporary results with ampullectomy for 29 "Benign" neoplasms of the ampulla
Journal of the American College of Surgeons, Vol.206(3), pp.466-471
03/01/2008
DOI: 10.1016/j.jamcollsurg.2007.09.005
PMID: 18308217
Abstract
BACKGROUND: Ampullectomy may be an appropriate oncologic procedure in selected patients. Sparse data exist on procedure-related complications and the relationship between histologic analysis and outcomes.
STUDY DESIGN: We retrospectively reviewed our experience with ampullectomy in 29 patients with a preoperative benign histologic diagnosis over 15 years (1991 to 2006). Presenting signs, symptoms, and preoperative diagnostic studies were reviewed. Postoperative complications and followup for recurrence were recorded. The abilities of preoperative histologic biopsy, intraoperative frozen section, and final histologic analysis to guide management and predict outcomes were determined.
RESULTS: Median age was 63 years. jaundice was present in 30% of patients. Median length of hospital stay was 9 days. Forty-five percent of patients had a complication, and there was one postoperative mortality (3%). Ampullary adenomatous neoplasms were present in 89% of patients. Preoperative biopsy had complete concordance with final pathology in 76% of patients. Preoperative biopsy and intraoperative frozen section failed to identify carcinoma in four patients. Pancreaticoduodenectomy was performed within 7 days in the postoperative period in three of these patients. After ampullectomy (median followup = 16 months), recurrences were identified in two patients (8%) with benign tumors. No patients with high-grade dysplasia (n=4) have had recurrence.
CONCLUSIONS: Preoperative biopsy and intraoperative frozen section analysis have limitations in the management of patients undergoing ampullectomy. High-grade dysplasia on preoperative biopsy is not an absolute contraindication to ampullectomy. Morbidity of ampullectomy is significant, but longterm outcomes of this procedure, in patients without invasive malignancy, are acceptable.
Details
- Title: Subtitle
- Contemporary results with ampullectomy for 29 "Benign" neoplasms of the ampulla
- Creators
- Stephen R. Grobmyer - University of FloridaChad N. Stasik - University of FloridaPeter Draganov - University of FloridaAlan W. Hemming - University of FloridaLisa R. Dixon - University of FloridaStephen B. Vogel - University of FloridaSteven N. Hochwald - University of Florida
- Resource Type
- Journal article
- Publication Details
- Journal of the American College of Surgeons, Vol.206(3), pp.466-471
- Publisher
- Elsevier
- DOI
- 10.1016/j.jamcollsurg.2007.09.005
- PMID
- 18308217
- ISSN
- 1072-7515
- eISSN
- 1879-1190
- Number of pages
- 6
- Language
- English
- Date published
- 03/01/2008
- Academic Unit
- Surgery
- Record Identifier
- 9984322953802771
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