| Theme |
Benign to Low-malignant Pancreatobiliary Lesionst |
| Title |
Ampullary Adenoma |
| Author |
Takao Itoi |
Department of Gastroenterology and Hepatology, Tokyo Medical University |
| Author |
Shujiro Tsuji |
Department of Gastroenterology and Hepatology, Tokyo Medical University |
| Author |
Toshio Kurihara |
Department of Gastroenterology and Hepatology, Tokyo Medical University |
| Author |
Atsushi Sofuni |
Department of Gastroenterology and Hepatology, Tokyo Medical University |
| Author |
Fumihide Itokawa |
Department of Gastroenterology and Hepatology, Tokyo Medical University |
| Author |
Takayoshi Tsuchiya |
Department of Gastroenterology and Hepatology, Tokyo Medical University |
| Author |
Nobuhito Ikeuchi |
Department of Gastroenterology and Hepatology, Tokyo Medical University |
| Author |
Reina Tanaka |
Department of Gastroenterology and Hepatology, Tokyo Medical University |
| Author |
Junko Umeda |
Department of Gastroenterology and Hepatology, Tokyo Medical University |
| [ Summary ] |
The pathology, diagnosis and treatment of ampullary adenoma are described. Through the use of conventional upper GI endoscopy we may observe superficial tumors spreading around the papilla and into the pancreatic duct or bile duct. Definitive diagnosis is usually obtained with biopsies. However, there are limitations on biopsy based diagnoses because the histological diagnostic criteria for ampullary adenoma have not yet been established. Nevertheless, biopsies are recommended since present imaging modalities are also limited in their ability to depict details of the ampulla of Vater. Pylorus-preserving pancreatoduodenectomies or local ampullary resection are standard operative procedures for ampullary adenomas. Recently, endoscopic papillectomies for ampullary adenomas without intrapancratic duct or bile duct tumor spreading, have been performed by a small number of endoscopists. |