Ampullectomy for adenoma of the papilla and ampulla of Vater
Ampullectomy for adenoma of the papilla and ampulla of Vater
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壶腹切除术治疗 Vater 乳头和壶腹腺瘤
DOI：
10.1007/s004230050117
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发表时间：
1998
期刊：
影响因子：
--
通讯作者：
M. Schoenberg
中科院分区：
文献类型：
--
作者：
H. Beger;L. Staib;M. Schoenberg
简介：乳头恶性腺瘤的发生率在15 - 30%之间。绒毛腺瘤被认为是一种癌前病变。治疗：大管状和小管绒毛状腺瘤适用乳头切除。然而，对于严重发育不良的绒毛状腺瘤和大的绒毛状或管状绒毛状腺瘤，壶胃切除术是强制性的。如果绒毛腺瘤伴低危pT1 N0 M0 g1 /2癌行壶胃切除术，还应行局部淋巴清扫。壶腹切除术包括壶腹水切除，并将胆总管和胰总管重新插入十二指肠壁。结果：壶胃切除术后住院死亡率低于0.4%，胆管炎等手术发病率低于10%。
Introduction:The frequency of malignant adenomas of the papilla figures between 15 and 30%. Villous adenoma is considered to be a premalignant lesion.Treatment:Resection of the papilla is indicated in large tubular and small tubulovillous adenoma. Ampullectomy, however, is mandatory in villous adenoma with severe dysplasia and large villous or tubulovillous adenoma. If villous adenoma with a low-risk pT1 N0 M0 G1/2-cancer is treated by ampullectomy, local lymph dissection should also be performed. Ampullectomy includes extirpation of the ampulla of Vater and reinsertion of the common bile duct and the pancreatic main duct into the duodenal wall.Results:Hospital mortality after ampullectomy is less than 0.4%, and surgical morbidity, e.g., cholangitis, below 10%.