Transduodenal ampullectomy for ampullary tumors.

Transduodenal ampullectomy (TDA) is indicated for large ampullary tumors, for presence of dysplasia on endoscopic biopsy, for poor surgical candidates for pancreaticoduodenectomy, and in cases not indicated for endoscopic ampullectomy. Retrospective review of data from 2009 to 2015 revealed 11 patients who underwent TDA. Magnetic resonance imaging cholangiopancreatography (MRI-MRCP), contrast-enhanced computed tomography (CECT) scan, side-viewing endoscopy, and endoscopic ultrasound (EUS) were used for investigating the patients as required. Preoperative biopsy was done in all. Out of the 11 patients, only one had recurrence. Two patients had adenocarcinoma and were treated with pancreaticoduodenectomy. TDA is a safe surgical procedure for treatment of well-selected benign ampullary pathologies. It is also a treatment option for the cases of ampullary adenomas not amenable to endoscopic resection.