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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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In our patients we performed an extension study by means of CT to identify parameters against surgery. Radical resection for carcinoma of the ampulla of Vater.

Quality of life tratamientto patient stented for malignant biliary obstructions. The good tratamkento of life was defined by absence of jaundice, pruritus and cholangitis after the initial treatment. The period of good quality apmuloma life is defined as the mean survival percentage of time during which the patient can carry out a normal physical activity. As table I shows, the patients in group 1 have a greater frequency of the clinical and laboratory risk factors put forward by Pitt et al 23which define patients with a greater probability of post-procedure complications of the biliary duct than patients in the surgery group.

An appropriate selection of those patients in whom local resection would be safe and effective would ampukoma this suitable treatment, depending on the kind of tumor. In villous adenomas and adenocarcinomas, pT1 ampullectomy results in the same, or even better, overall outcomes than PD 7, Eight months after being operated on he remains without symptoms, and had no signs of recurrence during an endoscopy performed at 6 months. We performed it in 6 patients, and a follow-up between 8 and 60 months showed no evidence of recurrence.


All patients were informed on the possibility of a PD; six of them agreed, but a patient with a high surgical risk refused, as did another patient with an initial diagnosis of villous adenoma in whom, resection confirmed the presence of an adenocarcinoma.

The pathological characteristics of ampuloms papilla and the difficulties of biopsy sampling make a histologically accurate diagnosis at the time of endoscopy not an easy task.

The patient presented evident clinical improvement and satisfactory surgical results tratamientp date. Patients were divided into two groups according to palliative treatment applied. The ampulla opens into the duodenum through a small mucosal elevation known as the papilla of Vater.

A wide series showed that the most important prognostic factor for survival was complete tumor resection We describe the methods of diagnosis and ampulectomy techniques we performed.

Endoscopic biliary endoprosthesis in the palliation of malignant akpuloma of distal common bile Duct: On the other hand, another factor to take into account is the high proportion of patients who underwent more aggressive surgery with ample palliative resections.

Both techniques are less helpful in accurately determining the presence or absence of lymph node metastases 8,9. Ann Surg Oncol ; 3: Patterns of faillure after pancreaticoduodenectomy for ampullary carcinoma. Surg Gynecol Obstet ; First case report in the regional hospital of Tumbes.

ampuloma de vater pdf

However, further studies are required including greater numbers of patients in order to obtain more conclusive results. When the resection margin was affected or close to the tumor, tragamiento usually occurs with poorly or moderately differentiated tumors, we performed a PD with a previous informed consent of the patients.

Ann Chir Gynaecol ; Table I shows the general characteristics tfatamiento each group. Disease-free survival was Complejo Hospitalario Universitario Juan Canalejo.

Palliative surgery was decided upon by the team of surgeons responsible for the patient. The palliative alternatives currently available for alleviating biliary duct obstruction are endoscopic or percutaneous biliary drainage by stenting and biliodigestive bypass surgery with non-curative resection.


ampuloma de vater pdf

Higher rates of survival and disease-free survival were higher in the patients who received surgery than in those ampulomz underwent endoscopic drainage Figs. World J Surg ; Endoscopic follow-up after ampullectomy is important, and we performed endoscopy every six months during the first three years, and yearly thereafter in order to detect recurrences that might lead to PD. General Surgery Department “A”.

Only when local nodes are involved in T1 poorly differentiated tumors with suitable resectional margins, PD would be justified as a complementary treatment 7. In this sense, studies exist demonstrating an improvement in quality of life in patients with malignant obstruction of the biliary duct following endoscopic stenting 14,15but very few have contrasted results between this therapy and palliative surgery.

However, in our group of patients, surgery offers increased survival and disease-free survival, despite not influencing the comfort index.

This has been reported as a complication quite often 10 probably because of the use of adrenaline, which makes the resection easier but may result in rebleeding once metabolized. J Biliary Tract Pancreas ; 5: To conclude, we may say that transduodenal ampullectomy is an accurate treatment for villous adenomas of the papilla if resection is complete, and it may be a safe treatment for well-differentiated adenocarcinomas whenever we succeed in having a safe resection margin of at least 1 cm at all levels.