Transduodenal excision of benign adenoma of the papilla of Vater.

OBJECTIVE

To evaluate methods of diagnosis and treatment of benign adenoma of the papilla of Vater.

DESIGN

Retrospective study.

SETTINGS

University hospital, Finland.

SUBJECTS

Five patients who had transduodenal excision of adenomas of the papilla of Vater from 1988-1993.

MAIN OUTCOME MEASURES

Symptoms, preoperative staging with side-viewing duodenoscopy and endoscopic retrograde cholangiopancreatography, histological appearance of operative frozen section, postoperative complications, and duodenoscopic follow up.

RESULTS

Only the patients with tumours less than 3 cm and strictures of the distal bile or pancreatic duct of less than 1.5 cm were selected for transduodenal excision. Both examination of operative frozen sections and final histological examination confirmed benign adenoma in each patient. Four of the patients recovered with no complications, but one patient developed bronchopneumonia. The preoperative symptoms (bleeding, jaundice, pancreatitis, pain) resolved in all patients. During the follow up (median 18 months) none of the patients developed recurrent disease.

CONCLUSION

This experience supports our policy of transduodenal excision of benign adenoma of the papilla of Vater for carefully selected patients.