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ORIGINAL ARTICLE
Year : 2015  |  Volume : 3  |  Issue : 3  |  Page : 70-74

Managing ampullary tumors: Our experience at University Teaching Hospital


1 Department of Surgery, Surgical Gastroenterology Units, Tribhuvan University Teaching Hospital, Kathmandu, Nepal
2 Department of Gastroenterology, Tribhuvan University Teaching Hospital, Kathmandu, Nepal

Correspondence Address:
Dr. Ramesh Singh Bhandari
Department of Surgery, Tribhuvan University Teaching Hospital, Kathmandu
Nepal
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2320-3846.178677

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Background: Ampullary tumors have been usually described together with other periampullary tumors. However, they have been found to behave differently in terms of their presentation, management, and perioperative outcomes. In this study, we try to analyze our experience in managing ampullary tumors in the tertiary level university teaching hospital. Materials and Methods: Retrospective review of the patients with ampullary tumors managed surgically over 10 years period (2004 January-2013 December) was carried out. Demographics, preoperative parameters, therapeutic procedures, postoperative morbidity and mortality were reviewed, and overall morbidity and mortality were compared with nonampullary group. Results: A total of 74 patients of ampullary tumors were managed over the study period. Jaundice was present in 65 (92.9%) patients at presentation. Pancreaticoduodenectomy (PD) was performed in 70 (66% of total PDs performed in the same period) cases while 4 patients had palliative bypass. There were no endoscopic resections and transduodenal ampullectomy in our series. On postoperative histology, two patients were found to have benign pathology. Postpancreatectomy fistula (30% vs. 11.1%) and other morbidities such as intra-abdominal collection and surgical site infection were higher in ampullary group. Mortality was comparable in both groups but overall mortality was higher than the published series. Conclusion: In tertiary centers of developing nations like ours, PD is still the main surgical procedure offered to the ampullary tumors. Ampullary tumors have higher perioperative morbidity than the nonampuallry group but have comparable mortality rates.


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