Abstract. KCAM, Eduardo; TAVARA, Franklin; MILLA, Ricardo and GONZALEZ, Steffi. Ampulloma treatment with Whipple surgery. First case report in the. findings by associating the ampuloma of pancreatobiliar origin with the infiltrative pattern, and .. y tratamiento del cáncer de páncreas. Med Clin (Barc). ampuloma de vater pdf. Quote. Postby Just» Tue Aug 28, am. Looking for ampuloma de vater pdf. Will be grateful for any help! Top.

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A case of ampullary carcinoma successfully managed with endoscopic snare resection. On the one hand, the generally advanced age of these patients usually leads to the association with serious diseases, making surgery unadvisable or significantly increasing postoperative morbidity and mortality 2,3. As stated previously, the purpose of applying palliative treatment to a patient ttratamiento malignant obstructive jaundice is not only to increase long-term survival, but also to maintain good quality of life during the period of time between the diagnosis of the disease and the patient’s death.

When the resection margin was affected or close to the tumor, which usually occurs with poorly or moderately differentiated tumors, we performed a PD with a previous informed consent of the patients. These facts have led to a change in treatment strategies by specialist centers, where surgeons experienced in this field prefer to perform tumor resections.

None of them was studied by endoscopic ultrasonography. Am Surg ; Local resection of tumors of the ampulla of Vater. The other patients remained without symptoms Table I. Ampullectomy was first described by Halsted in On the one hand, patient selection type for each treatment group must be taken into account.

The presence of these symptoms led us to perform hepatic function tests and an abdominal ultrasonography. Survival in both studies was greater after palliative resection than after bypass surgery.

Secretaria de Aparato Digestivo. Pancreatic involvement will lead to PD with lymphadenectomy, trstamiento of lymphatic spread after pancreatic dissemination, as it happened in two of our patients. Arch Surg ; With these results it may be stated that the quality of life provided by both palliative treatment procedures is similar in patients with malignant obstruction of the biliary duct.


In our series, patients who received endoscopic biliary drainage stayed in hospital for Table V shows disease-free survival, survival and comfort index by tumor location and type of palliative treatment used. On the other hand, the purpose of these treatments is not only to palliate jaundice and increase patient survival, but also to increase the disease-free survival between diagnosis and patient death.

In this sense, studies exist demonstrating an improvement in quality of life apmuloma patients with malignant obstruction of the biliary duct following endoscopic stenting 14,15but very few have contrasted results between this therapy and palliative surgery.

ampuloma de vater pdf

Group 1 included 50 patients who received endoscopic stenting. In any case, quality of life is a prognostic variable that has not been evaluated in controlled and randomized studies, and it would be necessary to define it accurately and analyze which is the best treatment option in order to offer the patient a healthier and more comfortable survival period. An appropriate selection of those patients in whom local resection would be safe and effective would allow this suitable treatment, depending on the kind of tumor.

Whipple surgery is the surgical technique of choice in the treatment of the ampullary adenocarcinoma and it is feasible to perform, in cases that is indicated, in bounderies hospitals if you have the trained personnel and necessary logistics.

ampuloma de vater pdf

However, they would be able to select patients who may be optimally managed by endoscopic resection. In tratajiento, Abraham Vater described a new anatomic entity that today is called the Vater’s ampulla 1. A dilatation of the bile duct was demonstrated in all patients by tratamientp, but its origin was not identified.

Patients with a prior history of another neoplastic disease during the 5 previous years were excluded, as were those with difficult endoscopic access to the papilla e.

Tumor of the ampulla of Vater. Thus, age, number of leukocytes, hemoglobinemia, serum levels of creatinine tdatamiento alkaline phosphotase are greater in the first group than in the second group. The pathological characteristics of the papilla and the difficulties of biopsy sampling make a histologically accurate diagnosis at the time of endoscopy not an easy task. None of the patients died, but two patients developed upper gastrointestinal bleeding UGBwhich were solved by endoscopic electrocoagulation 24 hours after surgery in one patient, and by embolization ampkloma the gastroduodenal artery in the other one.


Adenoma is the most frequent tumor, and its progression to villous adenoma and adenocarcinoma is admitted, much in the same way as the adenoma-carcinoma sequence in colon polyps. World J Surg ; Eight patients were treated by transduodenal ampullectomy, five males and three females.

Complejo Hospitalario Universitario Juan Canalejo. On the other hand, the evolutionary stage of these tumors anpuloma the time of diagnosis makes them non-resectable in many cases The hospital stay was registered after surgery or initial stent insertion, the number and causes of readmissions, and the need for new surgery on the biliary or digestive ducts.

Higher rates of survival and disease-free survival were higher in the patients who received surgery than in those who underwent endoscopic drainage Figs. They were distributed to endoscopic stent 50 and palliative surgical All patients were monitored until their death, with a revision 30 days after drainage and then quarterly, including analysis and abdominal ultrasound on each visit.

Follow-up ranged from 6 to 72 months. All of our patients were operated on by a right subcostal incision and, after cholecystectomy, the biliary duct was catheterized with a Fogarty catheter through the cystic duct in order to identify the papilla. Ampyloma malignant bile Duct obstruction. The period of good quality of life is defined as the mean survival percentage of time during which the patient can carry out a normal physical activity.

Complications of endoscopic retrograde cholangiopancreatography in jaundiced and cholestasic patients. The time free of disease was 4 months in stented patients and 10,5 months gratamiento surgical patients.