Department of Gastroenterology, Sendai City Medical Center, Sendai, Miyagi, Japan.
J Gastrointestin Liver Dis. 2011 Jun;20(2):205-7.
We herein report a case of ampullary cancer associated with pancreas divisum. Duodenoscopy revealed a tumor at the ampulla of Vater with a normal ampullary orifice. Intraductal ultrasonography showed a hypoechoic mass limited to the ampulla of Vater. ERCP showed an arborizing ventral pancreatic duct without connection to the dorsal duct. Endoscopic snare resection of the tumor was performed following biliary stenting. Histological examination revealed well-differentiated tubular adenocarcinoma limited to the ampulla of Vater. Endoscopic papillectomy with the assistance of a biliary stent is useful in cases of ampullary neoplasm with a normal ampullary orifice in order to avoid ductal injury.
我们在此报告一例与胰腺分裂相关的壶腹癌。十二指肠镜检查显示壶腹部有一肿瘤，壶腹部开口正常。胰胆管内超声显示局限于壶腹部的低回声肿块。ERCP 显示树状的胰管腹侧分支，与背侧分支无连接。胆管支架置入后行内镜下圈套切除术切除肿瘤。组织学检查显示肿瘤为局限于壶腹部的高分化管状腺癌。对于壶腹部有肿瘤但壶腹部开口正常的病例，在胆管支架的辅助下进行内镜乳头瘤切除术有助于避免胰管损伤。
