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Surgical ampullectomy:A comprehensive review

World Journal of Gastrointestinal Surgery 2021年第11期13卷 1338-1350页

作者： Darren L Scroggie Vasileios K Mavroeidis Department of Population Health Sciences Bristol Centre for Surgical ResearchBristol Medical SchoolBristol BS82PSUnited Kingdom Department of HPB Surgery University Hospitals Bristol and Weston NHS Foundation TrustBristol Royal InfirmaryBristol BS28HWUnited Kingdom Department of Surgery The Royal Marsden NHS Foundation TrustLondon SW36JJUnited Kingdom

tumours of the ampulla of Vater are relatively uncommon lesions of the digestive *** are typically diagnosed at an earlier stage than other types of tumours in this region,due to their tendency to invoke symptoms by obstructing the bile duct or pancreatic ***,many are potentially curable by *** ampullectomy(SA)(or transduodenal ampullectomy)for an ampullary tumour was first described in 1899,but was soon surpassed by pancreatoduodenectomy(PD),which offered a more extensive resection resulting in a lower risk of *** innovation in endoscopic techniques over recent decades has led to the popularization of endoscopic papillectomy(EP),particularly for adenomas and even early *** vast majority of resectable ampullary tumours are now treated using either PD or ***,SA continues to play a role in specific *** authors have suggested specific indications for SA based on their own data,practices,or interpretations of the ***,certain issues have attracted controversy,such as its use for early ampullary ***,there has been a lack of clarity regarding indications for SA,and no evidence-based consensus guidelines have been *** studies reporting SA have employed observational designs,and have been heterogeneous in their ***,characteristics of patients and their tumours have differed substantially across treatment ***,meaningful comparisons of clinical outcomes between SA,PD and EP have been ***,it appears that suitably selected cases of ampullary tumours subjected to SA may benefit from favourable peri-operative and long-term outcomes with very low mortality and significantly long survival,hence its role in this setting warrants further clarification,while it can also be useful in the management of specific benign *** the commissioning of a randomised controlled trial seems unlikely,well-designed obse

关键词： Ampulla of Vater ampullary tumours Surgical ampullectomy Transduodenal ampullectomy Endoscopic papillectomy Pancreatoduodenectomy

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