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01-12-2021 | Pancreatectomy | Original Article

Transduodenal surgical ampullectomy: a procedure that requires a multidisciplinary approach

Authors: Fabio Francesco di Mola, Paolo Panaccio, Tommaso Grottola, Antonio De Bonis, Giovanni Sapia, Maira Farrukh, Pierluigi di Sebastiano

Published in: Updates in Surgery | Issue 6/2021

Abstract

Trans-duodenal surgical ampullectomy (TSA) was first described in 1899. Nowadays its role in ampullary tumor surgery is still a matter of debate and requires a multidisciplinary approach. The aim of this study is to evaluate the results of TSA as a curative treatment for benign and selected malignant tumors arising from the ampulla in a single-institution experience. Sixteen patients with periampullary tumors that underwent TSA in our surgical units between January 2012 and January 2017 were included in the study. Patient demographic characteristics, pre or postoperative endoscopic interventions, operative procedures, postoperative morbidity and mortality, hospitalization, follow-up time, and quality of life questionnaire were analyzed. Mean operative time was 238.5 min (range 180–390), mean tumor size was 2.3 cm (range 1.5–3.9). The microscopic surgical outcome was R0 for 14 patients. The most frequent findings in terms of histological type were high-grade dysplasia/pTis (43.7%), low-grade dysplasia in 37.5% patients, invasive adenocarcinoma in 2 cases (12.5%), chronic inflammation in 1 case (6.3%). The readmission rate was 18.8% (3/16) and in 2 cases (12.5%) relaparotomy was required. The cumulative median duration of follow-up was 50 months (range 1–96). 90-days mortality was 6.2%. Mean hospital stay was 12 days (range 8–60). Our results confirm that TSA offers good results in terms of morbidity and mortality; still, it remains a challenging procedure that requires particular surgical experience and operative skills. A pre-operative planning in a multidisciplinary board should be carried out prior to the procedure.

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Title: Transduodenal surgical ampullectomy: a procedure that requires a multidisciplinary approach
Authors: Fabio Francesco di Mola
Paolo Panaccio
Tommaso Grottola
Antonio De Bonis
Giovanni Sapia
Maira Farrukh
Pierluigi di Sebastiano
Publication date: 01-12-2021
Publisher: Springer International Publishing
Keywords: Pancreatectomy
Endoscopic Retrograde Cholangiopancreatography
Published in: Updates in Surgery / Issue 6/2021
Print ISSN: 2038-131X
Electronic ISSN: 2038-3312
DOI: https://doi.org/10.1007/s13304-020-00951-y

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Transduodenal surgical ampullectomy: a procedure that requires a multidisciplinary approach

Abstract

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