Is It Suitable Laparoscopic Transduodenal Ampullectomy for the Treatment of Large Ampullary Tumors With High-grade Dysplasia?

Ki Byung Song, MD, Song Cheol Kim, PhD, Duck Jong Han, PhD, Jae Berm Park, MD, Young Hoon Kim, MD, Young Soo Jung, MD. Depetment of surgery, Ulsan University College of Medicine and Asan Medical Center

 

Aim : Transduodenal ampullectomy (TDA) can be performed for periampullary tumors. However, the laparoscopic approach has rarely been attempted. This study evaluated the safety and efficacy of laparoscopic TDA (L-TDA).

Material &Methods : From April 2009 to March 2011, 4 patiens with diagnosis of ampullary tumors, were unable to treated using endoscopic resection because of large size and evidence of malignancy based on endoscopic appearance, underwent L-TDA. We retrospectively reviewd the demographics, pathologic findings, and outcomes.

Result : Four patients underwent L-TDA in our center. The mean age of the patients was 51.8 ± 18.8 year old. There were 2 men and 2 women. Final pathology showed 2 tubular adenoma with high-grade dysplasia, 2 tubulovillous adenoma including 1 with high-grade dysplasia. The mean size of tumors was 3.8 ± 1.8 cm. The resection margin of all tumors was negative. Mean operative time was 197 ± 47.9 min and mean postoperative hospital stay was 12.5 ± 2.4 days. There were no recurrence and complications during 14.8 ± 9.9 months, mean follow up time.

Conclusion : L-TDA was feasible and safe for the treatment of ampullary tumors, especillay unsuitable for endoscopic resection. We must consider L-TDA as treatment option in ampullary tumors.
 


Session Number: Poster – Poster Presentations
Program Number: P361
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