The ampulla is a nipple-like structure located in the duodenum where the bile and pancreatic ducts open. The 2 cm area surrounding the ampulla, called the periampullary region, consists of four anatomical structures: the pancreatic head, the ampulla, the duodenum, and the distal common bile duct. Tumors that develop in this area are referred to as periampullary tumors.
What are the types of periampullary tumors?
- Duodenal tumors
Since the duodenum is located right next to the pancreas, tumors that develop here often grow into the pancreas.
Malignant tumors of the duodenum are usually removed using the Whipple procedure, while benign tumors of the duodenum can also be removed endoscopically.
- Tumors of the Vater papilla
Both benign and malignant tumors can develop in the Vater papilla, the common connection point of the pancreas and bile duct to the duodenum. For malignant tumors of the papilla, the Whipple procedure, which involves complete removal of the duodenum and pancreatic head, is required.
For benign tumors of the papilla, endoscopic methods can be preferred.
- Distal bile duct tumors
The distal part of the bile duct passes through the pancreatic head and reaches the duodenum. Removal of malignant tumors in the distal bile duct requires the Whipple procedure.
What are the types of periampullary tumors?
Periampullary tumors, which present with pain, weight loss, and jaundice, mostly occur in older age. Approximately 88% of patients are over 80 years old.
Which methods are used for the diagnosis of periampullary tumors?
For the diagnosis of all periampullary tumors, laboratory tests, imaging techniques such as ultrasound, CT, and MRI, as well as radiological or endoscopic interventional methods, are used.
How are periampullary tumors treated?
Because of their proximity to the pancreas, surgical interventions for tumors in the duodenum, Vater papilla, and distal bile duct require the removal of part of the pancreas.