Jeong Woo Lee, Sae Byeol Choi, Tae Wan Lim, Wan Joon Kim, Pyoungjae Park, Wan Bae Kim
Backgrounds/Aims: Patients with Ampulla of Vater cancer have a better prognosis than those with other periampullary cancers. This study aimed to determine the prognostic impact of lymph node metastasis on survival in patients with ampulla of Vater cancer after surgical resection. Methods: From 1991 to 2016, we retrospectively reviewed data on 104 patients with ampulla of Vater cancer who had received pancreaticoduodenectomy. Clinicopathologic factors such as lymph node ratio (LNR) and number of metastatic lymph nodes that influence survival were statistically analyzed...
February 28, 2021: Annals of Hepato-Biliary-Pancreatic Surgery
Soo Young Jang, Jin Sil Kim, Seung Yon Baek, Hye Ah Lee, Jeong Kyong Lee
PURPOSE: To stratify and weigh the computed tomography (CT) imaging and clinical features differentiating a neoplastic ampullary obstruction from a non-neoplastic ampullary obstruction and to develop a nomogram for estimating individualized risk of neoplastic potential in patients with a suspected ampulla of Vater (AOV) lesion on CT. METHODS: 135 patients (92 non-neoplastic and 43 neoplastic) with a suspected ampullary obstruction on a CT scan between February 2015 and May 2019 were included after the exclusion criteria were applied...
February 27, 2021: Abdominal Radiology
Mohammed S Al Qahtani, Shoukat A Bojal, Abdullah A Alqarzaie, Abdulaziz A Alqahtani
Pancreatic neuroendocrine tumors are rare with an incident rate of 5 cases per million individuals. Tuberous sclerosis complex is an autosomal dominant disease. This disease involves multisystem and occurs in one out of every 6,000-10,000 individuals. In this study, we describe a 47-year-old male known tuberous sclerosis patient with an insulinoma. The tumor was incidentally detected in follow-up imaging for a previous ampulla of Vater tubular adenoma. However, the patient reported symptoms of hypoglycemia...
March 2021: Saudi Medical Journal
Recep Ercin Sonmez, Fatih Buyuker, Rabia Burcin Girgin, Turgut Tunc Eren, Gurhan Bas, Orhan Alimoglu
A 78-year-old male patient with a history of the right hemicolectomy due to the adenocarcinoma was admitted by the complaint of epigastric discomfort. Laboratory data showed an increase in liver biochemistries (aspartate aminotransferase (AST): 159 IU/L, alanine aminotransferase (ALT):235 IU/L, alkaline phosphatase (ALP): 350 IU/L, gamma-glutamyl transferase (GGT): 911 IU/L, total bilirubin: 1.55 mg/dl and direct bilirubin: 0.82 mg/dl). Endoscopic retrograde cholangiopancreatiography (ERCP) administered after the gastrointestinal (GI) upper endoscopy was compatible with the tumoral lesion, and biopsy confirmed 'neuroendocrine carcinoma'...
2021: Northern Clinics of Istanbul
Dong Jae Shim, Su Ho Kim, Jung Kim, Ho Jong Chun, Doyoung Kim, Chanyeong Park
PURPOSE: To evaluate the safety and efficacy of percutaneous stone removal using a compliant balloon after papillary balloon dilatation. MATERIAL AND METHODS: Between March 2014 and May 2020, 123 patients with choledocholithiasis, in whom endoscopy was unsuccessful, were enrolled in this study. The ampulla of Vater was dilated using a noncompliant balloon, and stone removal was attempted via a pushing maneuver using an endoscopic stone extraction balloon. Clinical and technical success rates, complications, and risk factors for failure and complications were evaluated...
February 22, 2021: Minimally Invasive Therapy & Allied Technologies: MITAT
Alessandro Rizzo, Giovanni Brandi
Biliary tract cancer (BTC) includes a heterogeneous group of aggressive malignancies comprising gallbladder cancer (GBC), ampulla of Vater cancer (AVC), intrahepatic cholangiocarcinoma (iCCA), and extrahepatic cholangiocarcinoma (eCCA). Unfortunately, potentially curative resection is possible in approximately the 25% of presenting patients, and relapse rates are high, with a notable proportion of BTCs experiencing disease recurrence. Recent years have seen the publication of several prospective clinical trials evaluating the role of adjuvant systemic treatments, and among these, the phase III BILCAP study provided evidence supporting the use of capecitabine after radical surgery in BTC patients; in fact, although the study failed to meet its primary endpoint, the capecitabine arm showed improved clinical outcomes in terms of overall survival (pre-planned sensitivity analysis in the intention-to-treat population and in the per-protocol analysis) and relapse-free survival...
February 12, 2021: Cancer Treatment and Research Communications
Athina A Samara, Konstantinos Perivoliotis, Ioanna-Konstantina Sgantzou, Alexandros Diamantis, Theodoros Floros, Dimitrios Symeonidis, Konstantinos Tepetes
Gallstones may pass into the gastrointestinal tract spontaneously through the ampulla of Vater or through a biliary-enteric fistula. This report describes an extremely rare case of a patient vomiting a gallstone without the presence of a fistula between the gallbladder and the gastrointestinal tract. Furthermore, no imaging findings of gallstones disease appeared. The patient has been treated conservatively and all symptoms subsided. The patient remains asymptomatic 3 months after treatment and an elective laparoscopic cholecystectomy was arranged...
January 2021: Oxford Medical Case Reports
Partha Debnath, Amlan Kusum Datta, Uddalak Chakraborty, Atanu Chandra
Acute viral hepatitis has been associated with several extrahepatic complications. Fulminant liver failure secondary to acute viral hepatitis may be complicated by acute pancreatitis. However, in the setting of benign viral hepatitis, in the absence of liver failure, association of pancreatitis is uncommon, that too in an otherwise immunocompetent individual. The exact mechanism of hepatitis-related pancreatitis remains elusive. Proposed mechanisms include immune-mediated injury against infected pancreatic acinar cells, oedema of the ampulla of Vater and release of lysosomal enzymes from the liver...
February 4, 2021: BMJ Case Reports
Dan Huang, Hyundeok Joo, Nan Song, Sooyoung Cho, Woosung Kim, Aesun Shin
Objectives: Biliary tract cancers (BTCs) are rare but highly fatal. Although the etiology of BTC is poorly understood, gallstones are proposed to be an imperative risk factor. We conducted a systematic review and meta-analysis to examine the associations between gallstone characteristics and the risk of BTC. Methods: We searched the Medline, Embase, and Cochrane Central databases and systematically reviewed cohort and case-control studies published before April 9, 2018...
February 3, 2021: Epidemiology and Health
Jong-Sun Kim, Won Ho Choi, Kyung-Ann Lee, Hyun-Sook Kim
BACKGROUND: Immunoglobulin G4-related disease (IgG4-RD) is a multi-system fibroin-flammatory disorder that can involve any organ, including the salivary glands, pancreas, and biliary tree. Treatment of immunoglobulin G4-related sclerosing cholangitis (IgG4-SC) is similar to that for IgG4-RD, but progression is irreversible in some cases. We present a case of IgG4-SC in which an immuno-suppressant induced marked clinical and radiologic improvement. CASE SUMMARY: A 63-year-old male presented with a prominent itching sensation and wholebody jaundice...
January 6, 2021: World Journal of Clinical Cases
Ashis Pun, Amit Dhungana, Jewan Pariyar, Hari Prasad Upadhyay
BACKGROUND: Endoscopic retrograde cholangiopancreatography is carried out under moderate sedation mostly by use of propofol, opioids and benzodizepines. The aim of study is to assess difficulty in cannulation of ampulla of vater with the use of fentanyl. METHODS: A prospective randomized double blind comparative study was conducted at Bharatpur Hospital from August 2019 to August 2020 among patients undergoing Endoscopic retrograde cholangiopancreatography. Total 100 patients were enrolled in study and were divided in two groups - Group P (propofol and midazolam) and Group FP (propofol, midazolam and fentanyl)...
January 22, 2021: Journal of Nepal Health Research Council
Takamitsu Tanaka, Shunsuke Omoto, Mamoru Takenaka
No abstract text is available yet for this article.
January 28, 2021: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
Tomoya Hatakeyama, Kazuki Sakai, Sosuke Komiyama, Hidemasa Tamai, Shiro Ogino, Toshikazu Akami, Yuji Ueda, Takeshi Mazaki
An 80-year-old women admitted to our hospital with jaundice. Abdominal contrast-enhanced CT scan revealed an enhanced tumor, measuring 10 mm, at the duodenal ampulla. Upper endoscopy showed a submucosal tumor-like lesion at the duodenal ampulla. Immunohistochemical findings showed positive for chromogranin A and synaptophysin, and neuroendocrine carcinoma was diagnosed. Subtotal stomach-preserving pancreaticoduodenectomy with regional lymph node dissection was performed. The final diagnosis was large cell neuroendocrine carcinoma(LCNEC)...
December 2020: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Toshihiro Sato, Hisamune Sakai, Daisuke Muroya, Hiroki Kanno, Satoki Kojima, Syogo Fukutomi, Masanori Akashi, Yoriko Nomura, Yuichi Goto, Hiroto Ishikawa, Toru Hisaka, Yoshito Akagi, Koji Okuda
Annular pancreas is a rare congenital anomaly that rarely occurs in parallel with malignancy. We herein report a case of annular pancreas with carcinoma of the papilla of Vater. A 76-year-old woman presented with abdominal pain and was referred to us after gastroduodenal endoscopy showed a tumor of the papilla. Preoperative computed tomography confirmed the presence of an ampullary tumor. During surgery, we found an anomaly consisting of a ring-like band of pancreatic tissue encircling the second part of the duodenum...
December 2020: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Carissa Beaulieu, Arthur Lui, Dimas Yusuf, Zainab Abdelaziz, Brock Randolph, Eugene Batuyong, Sunita Ghosh, Oliver F Bathe, Vincent Tam, Jennifer L Spratlin
Background: Biliary tract cancers (BTC) are uncommon malignancies and are underrepresented in the literature. Methods: We performed a retrospective population-based review of adult patients with biopsy-confirmed BTC in Alberta from 2000 to 2015. Demographic data, risk factors, symptoms, treatment, and staging data were collected and analyzed. Survival analyses were completed. Results: A total of 1604 patients were included in our study, of which 766 (47.8%) were male. The median age at diagnosis was 68 (range 19-99)...
January 13, 2021: Current Oncology
Jiao Feng, RuiYang Wu, Gang Zhang, ZhiMing Yang, Liang Zhang
INTRODUCTION: The numbers of retrieved lymph nodes (RLNs) and positive lymph nodes (PLNs) had a significant impact on the survival of patients with ampulla of vater cancer (AVC), but the optimal numbers of the both were controversial. OBJECTIVE: The cohort study aimed to explore the prognostic value and the optimal point of RLNs and PLNs for AVC. METHODS: A total of 2347 AVC patients with M0 disease who underwent surgical resection and lymph node dissection from January 2004 to December 2013 were acquired from a prospective database...
2021: PloS One
Subhash Soni, Poonam Elhence, Vaibhav Kumar Varshney, Sunita Suman
Squamous cell carcinoma (SCC) of the ampulla of Vater is a rare pathology and only few cases are reported in the literature. With limited experience of primary SCC in the ampulla of Vater, its biological behaviour, prognosis and long-term survival rates are not well known. A 38-year-old woman presented with a history of painless progressive jaundice for which self-expending metallic stent was placed 3 years back. She was evaluated and initially diagnosed as probably periampullary adenocarcinoma. She underwent pancreaticoduodenectomy and histopathology with immunohistochemistry was suggestive of SCC of ampulla of Vater...
January 7, 2021: BMJ Case Reports
Alessandro Rizzo, Alessandro Di Federico, Angela Dalia Ricci, Giorgio Frega, Andrea Palloni, Rachele Pagani, Simona Tavolari, Mariacristina Di Marco, Giovanni Brandi
BACKGROUND: Biliary tract cancers (BTCs) represent a heterogeneous group of aggressive solid tumors with limited therapeutic options, and include gallbladder cancer (GBC), ampulla of Vater cancer (AVC), intrahepatic cholangiocarcinoma (iCCA) and extrahepatic cholangiocarcinoma (eCCA). METHODS & RESULTS: In the current review, we will discuss recent results of clinical trials testing targeted therapies in BRAF-mutant BTCs, with a particular focus on the recently published Phase II ROAR trial and ongoing active and recruiting clinical trials...
January 2020: Cancer Control: Journal of the Moffitt Cancer Center
Li-Jia Wen, Jun-Hong Chen, Hong-Ji Xu, Qiong Yu, Yu Deng, Kai Liu
BACKGROUND: Mixed neuroendocrine nonneuroendocrine neoplasms (MiNENs) originating from the biliary system (gallbladder, biliary tract, or ampulla of Vater) are extremely rare and have not been discussed in detail or systematically. We aimed to present the demographics, clinicopathological characteristics, management, and prognostic factors of biliary MiNENs. METHODS: A systematic search of electronic biomedical databases (Web of Science, PUBMED, and Embase) was performed to identify eligible studies...
December 11, 2020: Medicine (Baltimore)
Alessandro Rizzo, Giovanni Brandi
Biliary tract cancer (BTC) is a heterogeneous group of aggressive malignancies comprising ampulla of Vater cancer, gallbladder cancer, extrahepatic cholangiocarcinoma, and intrahepatic cholangiocarcinoma; unfortunately, the incidence of distant and locoregional recurrence remains high in resected BTCs, with approximately 60-70% of patients which will experience disease relapse. Until a few years ago, adjuvant treatment was mainly based on the results of a meta-analysis including heterogeneous retrospective studies and showing a survival benefit in the selected populations of resected BTC patients with node-positive disease and/or R1 resection...
December 13, 2020: Expert Review of Gastroenterology & Hepatology
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