Herzog J, Eickhoff A
Klinikum Hanau, Medizinische Klinik II, Deutschland.
Zentralbl Chir. 2012 Dec;137(6):527-34. doi: 10.1055/s-0031-1283869. Epub 2012 Jun 18.
Ampullary tumours are rare and can be separated in benign and malignant lesions. There are non-invasive diagnostic methods in order to detect ampullary tumours like abdominal ultrasound, computed tomography and MRCP (magnetic resonance cholangiopancreaticography) as well as invasive methods, e. g., gastroscopy, duodenoscopy, endosonography, intraductal ultrasound, ERCP and cholangioscopy. Endoscopy is the method of choice for this indication, whereas a combination of the different diagnostic methods is common.
A selective literature research with descriptive survey has been carried out.
The standard method to treat benign tumours of the papilla is endoscopic papillectomy. For malignant tumours surgery is preferred. But in some certain circumstances it is also possible to treat carcinomas of the papilla endoscopically.
This overview should assist surgeons and endoscopists to choose the right diagnostic approach and to treat adenomas as well as carcinomas of the Papilla of Vater appropriately.
The treatment of papilla tumours depends primarily on the dignity, the morphology of the findings and the extension of the tumour (extraductal vs. intraductal).
壶腹肿瘤较为罕见,可分为良性和恶性病变。有多种非侵入性诊断方法用于检测壶腹肿瘤,如腹部超声、计算机断层扫描和磁共振胰胆管造影(MRCP),也有侵入性方法,例如胃镜检查、十二指肠镜检查、内镜超声检查、导管内超声检查、内镜逆行胰胆管造影(ERCP)和胆管镜检查。内镜检查是该适应证的首选方法,而不同诊断方法联合使用也很常见。
进行了一项采用描述性调查的选择性文献研究。
治疗乳头良性肿瘤的标准方法是内镜下乳头切除术。对于恶性肿瘤,首选手术治疗。但在某些特定情况下,也可以通过内镜治疗乳头癌。
本综述应有助于外科医生和内镜医生选择正确的诊断方法,并适当治疗十二指肠乳头腺瘤和癌。
乳头肿瘤的治疗主要取决于肿瘤的性质、检查结果的形态以及肿瘤的范围(导管外与导管内)。