BENIGN-TUMOR OF THE AMPULLA OF VATER - SURGICAL-TREATMENT AND PROGNOSIS

Objective: To find out whether wide local resection is adequate treatm ent for patients with benign tumours of the papilla of Vater. Design: Retrospective study. Setting: University hospital, Germany. Subjects: 31 patients with benign tumours out of a total of 129 with lesions of the ampulla of Vater treated between May 1978 and February 1995. Inter ventions: Histological examination of specimens before, during, and af ter the operation. Main outcome measures: Sensitivity and positive pre dictive value of histologial examination, and outcome of treatment. Re sults: Histological examination before and during the operation had a sensitivity of 89% and 97%, respectively. 28 patients were treated by wide excision of the ampulla and 3 by pylorus-preserving partial pancr eaticoduodenectomy. At a median follow up of 43 months (range 6-156) t here was no evidence of recurrent disease. Conclusion: Wide excision o f the ampulla with reconstruction and reimplantation of the duet is ad equate treatment for benign lesions. If the histological picture is un certain, partial pancreaticoduodenectomy is justified in patients at l ow risk.