Surgical approaches to benign and malignant tumors of the ampulla of vater.

Ampullary tumors include a diverse group of benign and malignant neoplasms. A surgical approach to their management was initiated in 1899 by Halsted and continues to evolve. Surgical options include a spectrum of operative procedures designed to relieve symptoms and to remove malignant or potentially malignant tumors. This article discusses the issues relevant to ampullary tumor management with emphasis on the currently accepted and controversial aspects of the surgical approach.