SURGICAL TREATMENT OF THE AMPULLARY TUMOR -WIDE LOCAL EXCISION AS AN ALTERNATIVE TREATMENT FOR AMPULLARY TUMOR-

Between 1983 and 1994, five patients (two men and three women) with ampullary tumor were treated surgically. Their ages ranged from 62 to 86 years. Three patients presented with signs of obstructive jaundice. Another two patients without complaints were diagnosed as having choledochus dilatation and gallbladder stone by abdominal echogram. The diagnosis of ampullary tumor was established preoperatively by percutaneous transhepatic cholangiography in one patient, and by endoscopy in four patients. Wide local excision of ampullary tumor has been performed in patients at high risk for radical resection. The procedure may be suitable for selected patients among elderlies and poor-risk patients who have a tumor of small size with some underlying disease, because of low operative morbidity and mortality compared with those of pancreaticoduodenectomy. The rationale of this operative procedure is discussed in the current literature.