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Cirugía paraguaya

On-line version ISSN 2307-0420


ADORNO, Carlos; RODRIGUEZ, Ramón; PEREZ, Rodrigo  and  CABRERA, Ruth. ENDOSCOPIC AMPULECTOMY. NATIONAL HOSPITAL OF ITAUGUA. Rev. Cir. Parag. [online]. 2019, vol.43, n.1, pp.32-34. ISSN 2307-0420.

The ampullary tumors correspond to those located at the junction of the terminal segments of the pancreatic and common bile duct. They constitute between 1 and 2% of the tumors of the digestive tract, are characterized by their slow growth and correspond to the periampullary tumors with the best prognosis. There are several therapeutic options, one of them is endoscopic resection. We present the clinical case of a 70-year-old man who consulted due to progressive jaundice, choluria, acolia and abdominal pain. Abdominal CT is suggestive of periampullary neoplasia. Endoscopic retrograde cholangiography showed an irregular and friable proliferative lesion located in the ampulla of Vater, suggestive of ampuloma. Papillotomy, biliary stenting, and papilla biopsy are performed. Biopsy reports adenocarcinoma of the ampulla of Vater. The proposed treatment was endoscopic ampullectomy. The pathological anatomy of the resected specimen concludes villous adenoma with foci of high grade dysplasia and intramucosal carcinoma without evidence of invasion of the submucosa.

Keywords : periampullary tumors; endoscopic ampullectomy.

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