ENDOSCOPIC MANAGEMENT OF TUMORS OF MINOR AMPULLA: A MULTICENTER CASE STUDY

Aims Tumors arising in the minor ampulla are relatively rare and there is little research available on the management of these tumors. The purpose of this study is to establish the safety and efficacy of endoscopic ampullectomy in the management of minor ampullary tumors.

Methods Patients undergoing ampullectomy for minor ampullary tumor at four hospitals were included in this study over a period of 5 years. Six patients were included in the study and all six patients underwent ERCP for the purpose of minor ampullectomy. MRCP and EUS were performed on all patients prior to ERCP to rule out evidence of invasive disease.

Results The tumors varied in size from 1 cm to 3 cm. Pathology revealed adenoma in three patients, adenoma with high grade dysplasia in one patient, carcinoma in one patient, and carcinoid tumor in one patient. Follow-up for these patients ranged from 2 to 5 years with EGD using duodenoscope at 3 months, at one year and yearly thereafter. One patient had an additional tumor identified at 2 years which was found to be a recurrence of the original adenoma. This patient was treated with repeat ampullectomy with no further evidence of recurrence. The patient with carcinoma had endoscopies every 3 months for a year followed by yearly endoscopy; no recurrence was noted during the 3 years of followup.

Fig. 1

Conclusions In our pilot study, we demonstrate that endoscopic ampullectomy appears safe and effective in the management of minor ampullary tumors.

Publication History

Article published online:
14 April 2022