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International Journal of Clinical and Experimental Medicine Research

Transduedonal Excision Of Ampullar Adenoma; Case Report

Author:Mehmet Fatih CAN¹, Yaşar Subutay PEKER¹, Şahin KAYMAK¹, Sezai DEMİRBA޲ Date:July 25,2018 Hits:

Abstract

Introduction: Diagnosis/treatment/follow-up of ampullar adenomas are tough cases for clinicians because of their localizations. Treatment of ampullar adenomas has a wide range from endoscopic excision to pancreaticoduedenectomy (PD) where transduedonal ampullectomy (TdA) is one of them. This case report aimed to share our experiences about ampullar adenoma, which endoscopic excision was not able to be applied and TdA was successfully performed.

Case Report: 72-years-old-male patient applied to gastroenterology clinic with inci-dentally diagnosed increase at cholestatic enzymes. Patient was diagnosed as ampullar adenoma, which was endoscopicaly excised. The histopathologic evaluation was re-ported as 2.5x2.5x1.5cm low grade displastic ampullar adenoma with minimal high grade displasia and positive surgical margins. The patient applied to our clinic and TdA was planned to the patient considering him not having invasive tumour diagnosis, his age and comorbidities. TdA was successfully performed with negative surgical mar-gins. Postoperative bile drainage as observed and medical treatment for 25 days was applied. The bile leakage interrupted on postoperative 25th day and patient was dis-charged on 29th day.

Conclusion: Surgery is the only alternative to endoscopic excision for ampullar ade-noma and TdA is superior to PD when no invasive tumor is diagnosed and ASA score of the patient is high.  For this reason we believe that TdA is a feasible technique for ampullar adenomas if the adenoma is not suitable for endoscopic resection because of its size or if the resection margins of the adenoma with dysplasia are positive.


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Transduedonal Excision Of Ampullar Adenoma; Case Report 
Mehmet Fatih CAN¹, Yaşar Subutay PEKER¹, Şahin KAYMAK¹, Sezai DEMİRBA޲
¹University of Medical Sciences, Gülhane Training and Research Hospital, Department of General Surgery, Turkey
²TOBB-ETÜ University Hospital, Department of General Surgery, Turkey
*Corresponding to: Yaşar Subutay PEKER, University of Medical Sciences, Gülhane Training and Research Hospital,   Department of General Surgery, General Tevfik Saglam Blvd, No: 1 Etlik Kecioren Ankara Turkey 06010
Email: subutaypeker@gmail.com

How to cite this paper: CAN, M.F.,  PEKER, Y.S., KAYMAK, Ş., DEMİRBAŞ, S. (2018) Transduedonal Excision Of Ampullar Adenoma; Case Report. International Journal of Clinical and Experimental Medicine Research, 2(7), 90-92.
DOI: 10.26855/ijcemr.2018.07.001

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