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BMC Surgery
Published in: BMC Surgery 1/2016

Open Access 01-12-2016 | Research article

Transduodenal ampullectomy provides a less invasive technique to cure early ampullary cancer

Authors: Yang Gao, Yayun Zhu, Xiuyan Huang, Hongcheng Wang, Xinyu Huang, Zhou Yuan

Published in: BMC Surgery | Issue 1/2016

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Abstract

Background

The aim of this study was to evaluate the clinical efficiency of transduodenal ampullectomy (TDA) compared to conventional pancreatoduodenectomy (PD) in patients with early ampullary cancers.

Methods

We carried out a retrospective study by reviewing the medical records of 43 patients with early ampullary cancer who underwent either TDA or PD from January 2001 to December 2014. TDA and PD were performed on 22 patients and 21 patients, respectively. Clinical data, perioperative clinical outcomes and prognosis were evaluated. The median follow-up was 75 (range, 38–143) months.

Results

The sensitivity of intraoperative frozen resection was 100 % (4/4) and 94.9 % (37/39) in patients with pTis and pT1 tumors compared to final histologic diagnoses. The 5-year survival rate of patients with early ampullary cancer was 77.3 % in TDA group and 75.9 % in PD group (P = 0.927). Patients with lymph node metastasis presented a shorter 5-year survival rate (P = 0.014). TDA was associated with lower surgical morbidity (P = 0.033), estimated blood loss (P = 0.002), medical cost (P = 0.028) compared to PD. No pancreatic fistula and surgical mortality occurred in TDA group.

Conclusions

TDA could produce satisfactory clinical efficiency in patients fulfilled the following criteria simultaneously: pTis or pT1 stage, tumor size ≤ 2 cm, without lymph node metastasis. To achieve favorable outcomes, intraoperative frozen section examinations should be reliable and resection margins should be negative.
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Metadata
Title
Transduodenal ampullectomy provides a less invasive technique to cure early ampullary cancer
Authors
Yang Gao
Yayun Zhu
Xiuyan Huang
Hongcheng Wang
Xinyu Huang
Zhou Yuan
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Surgery / Issue 1/2016
Electronic ISSN: 1471-2482
DOI
https://doi.org/10.1186/s12893-016-0156-z

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