Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “VATER'S AMPULLA”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 19 recordsLinked to original sources
PubMed1997

Villous tumors of the ampulla Vater.

Patients with villous tumors of the ampulla Vater usually present with jaundice, intermittent or constant, but may seek care for abdominal pain, intestinal hemorrhage, or pancreatitis. Because villous tumors may harbor carcinoma in 30 to 50 per cent of cases, appropriate management may require radical resection. We have managed four patients with villous lesions of the ampulla Vater occurring in 1981, 1992, 1993, and 1995. Three were villous (two with malignant change) and one was a villoglandular adenoma. Treatment consisted of local excision with reimplantation of the ducts in one patient, Whipple resection in two patients, and biliopancreatic bypass in one who had distant nodal metastases not resectable for cure. This patient died 18 months after operation of an unrelated disease, but the others were well at last follow-up. The presentation as well as the diagnostic and therapeutic considerations in the management of villous tumors of the ampulla Vater are discussed.

Adenoma, Villous↗
PubMed2005

Trefoil factor family (TFF) peptides of normal human Vater's ampulla.

Vater's ampulla is of great clinical relevance with regard to the influx of chyme, ascending inflammation, intubation during diagnostic and therapeutic endoscopic maneuvers, therapeutic papillotomy and, especially, the formation of malignancies. Little is known about the distribution of trefoil factor family (TFF) peptides in the ampulla. We have therefore examined TFF peptide distribution in the normal ampulla of Vater and compared it with that in duodenal mucosa and Brunner's glands. Expression and synthesis of TFF peptides in Vater's ampulla and duodenum was investigated by reverse transcription-polymerase chain reaction, Western blot and immunohistochemistry. The samples studied originated from 30 autopsy cases with short postmortem intervals. TFF3 was expressed in the ampulla of Vater. mRNA expression of TFF1 was detected in only approximately 25% of the investigated samples. Western blot revealed the production of TFF3 and immunohistochemistry showed that TFF3 was the product of goblet cells. TFF peptide composition of Vater's ampulla varied in comparison with that in the duodenum regarding TFF2 expression. The ampulla of Vater thus has a unique profile of TFF peptide production, supporting the hypothesis that the ampulla is an autonomous organ. The observed differences in the TFF peptide distribution between the duodenum and Vater's ampulla favour the investigation of TFF peptides as prognostic markers in the classification of ampullary carcinomas.

Adult↗
PubMed2003

A novel cell line and xenograft model of ampulla of Vater adenocarcinoma.

Ampulla of Vater cancers (AVC) are of clinical relevance, as they represent more than one-third of patients undergoing surgery for pancreaticoduodenal malignancies and have a better prognosis than periampullary cancers of pancreaticobiliary origin. The availability of cellular models is crucial to perform cell biology and pharmacological studies and clarify the relationship between AVC and pancreatic and biliary cancers. Numerous cell lines are available for pancreatic and biliary adenocarcinomas, while only two have been reported recently for AVC. These were derived from a poor and a well-differentiated AVC, and both had wild-type K- ras and mutated p53. We report the establishment of a novel AVC cell line (AVC1) derived from a moderately differentiated cancer, having a mutated K- ras, wild-type p53, and methylated p16. Thus, our cell line adds to the spectrum of available in vitro models representative of the different morphological and molecular presentations of primary AVC. We further characterized AVC1 for the expression of relevant cell surface molecules and sensitivity to chemotherapeutic agents of common clinical use. It expresses MHC-I and CD95/Fas, while HLA-DR, CD40, CD80, CD86, MUC-1, MUC-2, and ICAM-1/CD54 are absent. It has a low to moderate sensitivity to both 5-FU and gemcitabine, at variance with much higher sensitivity displayed by two pancreatic ductal carcinoma cell lines. Lastly, AVC1 can be readily xenografted in immunodeficient mice, making it a suitable model for pre-clinical studies.

Adenocarcinoma↗
PubMed1986

[Development of carcinoma of Vater's ampulla in an adenoma. Analysis of a personal case load and review of the literature].

A retrospective analysis was undertaken of our case material of 40 histological preparations of carcinoma of the ampulla of Vater, as well as a survey of the literature of 103 adenomas of the ampulla of Vater. Signs of malignant transformation were detected in 25% of the adenomas, whilst adenomatous residues were identified in 72% of the examined carcinomas of the ampulla of Vater. Thus, an adenoma-carcinoma sequence seems to be as significant in the case of Vater's papilla as in the colo-rectal region. An epidemiological investigation confirms this hypothesis since 1. adenomas of the papilla Vateri develop 4 years prior to a carcinoma and 2. the relative sex distribution of the two diseases is approximately equal.

Adenoma↗
PubMedDate not supplied

[Signet-ring cell carcinoma of the Vater's ampulla: report of a clinical case].

We report the case of a sixty-six year-old man admitted at our hospital with a suspected malignant tumor of the ampulla of Vater. The patient underwent a Pylorus-preserving pancreatico-duodenectomy. Histology showed a signet-ring cell carcinoma of the ampulla of Vater. This case is the 13th report in the literature of a signet-ring cell carcinoma of the ampulla of Vater.

Aged↗
PubMed1994

[Palliative endoscopic treatment of adenocarcinoma of Vater's ampulla: medium and long-term results].

The palliative endoscopic treatment of tumors of the ampulla of Vater provides good short-term symptomatic results, while long-term results remain unknown. This study to assessed the course of 17 patients with carcinoma of the ampulla of Vater treated palliatively by endoscopy and monitored for a 5-year-period. From january 1985 to december 1989, 35 patients were diagnosed as having carcinoma of the ampulla of Vater. For 18 of them, curative surgery was performed, while for the 17 remaining 17 patients, palliative endoscopic treatment was proposed because of metastatic extension or surgical risk. Endoscopic treatment always included endoscopic sphincterotomy, and, in some cases, insertion of a biliary endoprosthesis. All patients were monitored until death or the end of follow-up on September 30, 1990. Endoscopic sphincterotomy was performed in 13 of the 17 patients, either alone in 10 cases, or with prosthesis in the other 3 cases. For the 4 other patients, endoscopic sphincterotomy could not be performed (large tumor in 2 cases, presence of duodenal diverticulum in 2 other cases). The 13 patients who underwent endoscopic treatment experienced rapid symptomatic improvement. Jaundice and cholangitis consistently recurred within a period of 1 to 44 weeks regardless of initial treatment. All recurrences except one, were successfully retreated by endoscopy (enlargement of initial sphincterotomy in 6 cases, insertion or replacement of prosthesis in 12 cases).(ABSTRACT TRUNCATED AT 250 WORDS)

Adenocarcinoma↗
PubMed1986

[Coexistence of an extensive tubulovillous adenoma of the duodenum and a cancer of Vater's ampulla].

In the present paper we report about a patient with a large tubulo-villous duodenal adenoma associated with a carcinoma of the ampulla of Vater. Despite of lacking pre- and intraoperative evidence of malignancy a Whipple operation was performed because of extensive growth of the duodenal adenoma and its location near the ampulla of Vater. The carcinoma of the ampulla could be diagnosed only postoperatively in the resected duodenum. The problems of the presented case and the operative procedure is discussed based on a review of the literature.

Adenocarcinoma↗
PubMedDate not supplied

[Villous adenoma of the Vater's ampulla].

Benign tumors of the ampulla of Vater are rare. The villous adenoma, the most common benign tumor of this region, has a high tendency to malignant transformation. Postmortem studies showed an incidence of 0.04-0.12% adenomatous lesions of the papilla of Vater. The authors present a case of villous adenoma of the ampulla of Vater and make a review of the literature.

Adenoma, Villous↗
PubMed1995

[Neurofibromatosis (von Recklinghausen disease) and carcinoid tumor in Vater's ampulla].

The localization of the carcinoid tumors of the gastrointestinal tract--as a part of the APUD system--is extremely seldom at the region of ampulla of Vater. A case of congenital neurofibromatosis is reported in a 49-year-old male patient, with a carcinoid tumor of the ampulla of Vater in the background of long-standing, atypical biliary complaints. Periampullary neoplasm of neural-crest origin are very rare, up to this time 73 cases of Vater papilla carcinoid tumors were described. Regarding the development of VP carcinoid in neurofibromatosis, our patient is the 21st reported case in the world literature, and the first one in Hungary. The authors review the literature, giving special attention to the risk of periampullary neoplasms in von Recklinghausen's disease, the need of accurate diagnosis and the correctly selected operative intervention.

Ampulla of Vater↗
PubMed1997

[Congenital duodenal diaphragm in an adult associated with an abnormal location of Vater's ampulla: a case report and review of the literature].

Web-related duodenal obstruction in the adult is rare, so is the anomalous location of the ampulla of Vater in the third part of the duodenum. A woman who harboured both anomalies is described and the literature reviewed. The diagnosis, often made at laparotomy, mandates an exploratory duodenotomy. The best treatment consists of partial excision of the web and transverse closure of the duodenum. A duodenojejunostomy or duodenoduodenostomy, or both, are acceptable therapies. The anomalous location of the ampulla of Vater in the third part of the duodenum does not require treatment.

Ampulla of Vater↗
PubMedDate not supplied

[Endoscopic diagnosis of tumors of Vater's ampulla].

The diagnosis of ampulla of Vater tumors is complex due to the proximity of other anatomical structures that are the originating sites of tumors with different natural histories, treatment and prognosis. A retrospective study of 65 consecutive patients with conclusive ampulla of Vater tumor diagnosis from January 1994 to April 1998 was conducted. Icterus was the principal symptom in 92%. In 34/65 patients on whom ultrasound or CT scan were performed, nearly half showed only dilation in the bile ducts, an ampullar tumor was suspected in six, in another six, pancreatic tumor was suspected and then discarded, and seven had no specific findings. Endoscopic imaging discovered the tumor in all of the cases, but the biopsy was diagnostic in only 84.6%: forty-eight carcinomas were discovered in addition to six adenomas (two with carcinoma and one with dysplasia) and one lymphoma. A diagnosis was arrived at in ten patients with negative biopsies through other means. Surgeries uncovered two carcinoids with endoscopic diagnosis of carcinoma. It was concluded that endoscopy is a good diagnostic method that allows palliation; however, it requires a perfecting process such as endoluminal ultrasound, specially if, taking into consideration the elevated morbimortality involved in pancreatoduodenectomies, conservative treatment is sought.

Adenocarcinoma↗
PubMed1993

[Value of image analysis DNA cytometry in cancer of Vater's ampulla].

In 27 patients who underwent partial duodenopancreatectomy due to cancer of the ampulla of Vater, in addition to the TNM classification and usual morphologic criteria, the paraffin-embedded material underwent deparaffinization, was rehydrated, and was mechanically and enzymatically processed into a single-cell solution. For evaluating the DNA histogram this was analyzed with the help of automatic single cell cytophotometric study. At the time of DNA analysis the histomorphological data and the survival time of the patients were not known. In the univariate analysis the 5-year survival rate of patients with diploid or hypotriploid tumors (n = 12) was 69% of patients with diclonal (diploid-triploid n = 7, triploid-tetraploid n = 1) tumors was 62.5% and no patient with a triploid or hypertriploid tumor (n = 7) survived 5 years. No association could be found between the known prognostic criteria and the DNA content. The multivariate analysis shows that beside the lymph node status, the DNA content of tumor cells had a strong and independent influence on the prognosis in cancer of the ampulla of Vater.

Adenocarcinoma↗
PubMed2000

[Treatment concept of adenomas of Vater's ampulla].

INTRODUCTION: The most common benign ampullary tumors are adenomas (80%). They are considered as premalignant lesions with a transformation rate to carcinoma of up to 30%. METHODS: From 1 January 1997 to 28 February 1999 we treated 11 patients with adenoma of the ampulla of Vater. An ampullectomy was performed in 10 cases. One poor-risk patient could not be operated on. RESULTS: No operative mortality occurred. In two patients a pT1 adenocarcinoma was diagnosed postoperatively. One of the two patients with a high-risk carcinoma underwent a second operation, a Whipple pancreatoduodenectomy. Nine of 10 patients had no recurrence with a median follow-up of 12 months. CONCLUSION: One patient died of glioblastoma. We would therefore recommend ampullectomy as the first-line treatment for benign tumors of the ampulla of Vater. In low-risk pT1 carcinoma (G1/G2, L0) and R0 resection, local excision is acceptable. In high-risk pT1 carcinoma (G3 and/or L1) Whipple pancreatoduodenectomy is mandatory.

Adenocarcinoma↗
PubMedDate not supplied

[Precut sphincterotomy in impacted choledocholithiasis at the Vater's ampulla].

BACKGROUND: Endoscopic sphincterotomy is an established treatment for common bile duct stones. Stone impaction at the ampulla makes deep cannulation and standard sphincterotomy more difficult. The use of precut papillotomy may facilitate stone extraction, although risks may be greater. AIM: To evaluate precut papillotomy in impacted common bile duct stone at the ampulla of Vater. PATIENTS AND METHODS: Between October 1990 and September 1995, 27 of 345 patients with common bile duct stones underwent needle knife precut papillotomy after conventional sphincterotomy failed due to impacted ampullary stone. This facilitated deep cannulation and subsequent standard sphincterotomy in 12 patients. RESULTS: Eleven patients had spontaneous expulsion of the stone when precut papillotomy was extended. Oedema or bleeding precluded stone extraction in 3 patients, and these stones were removed at a second endoscopic retrograde cholangiopancreatography (ERCP) session. Mild bleeding occurred in one patient and hemotransfusion was necessary. There was no perforation or pancreatitis following the procedure. CONCLUSIONS: Precut papillotomy is effective in the treatment of impacted common bile duct stone at the ampulla of Vater. It's a technique that should be performed only by an experienced endoscopist and does not increase the complications risk.

Adult↗