Ampullary carcinoma is often of mixed or hybrid histologic type: an analysis of reproducibility and clinical relevance ofclassification as pancreatobiliary versus intestinal in 232 cases.
Fischer, "Annular pancreas associated with coexistent
ampullary carcinoma in an elderly woman," Canadian Journal of Surgery, vol.
Pancreaticogastrostomy for reconstruction of pancreatic stump after pancreaticoduodenectomy for
ampullary carcinoma. Am J Surg 1998; 176: 274-8.
4: Sex-wise distribution of various Diseases as Observed on MRCP Male Female acute pancreatitis 10 chronic pancreatitis 4 cholelithiasis 4 choledocholelithiasis 6 cholelithiasis with 14 choledocholelithiasis choledochal cyst 2 gall bladder carcinoma 4 cholangiocarcinoma 6 peri
ampullary carcinoma 4 stricture 4 Note: Table made from bar graph.
In contrast, retrospective evaluations of pancreatic cancer and
ampullary carcinoma demonstrated that the number of metastatic nodes, but not LNR, was one of the most important prognostic factors [21, 22].
The most common malignancy in this study was pancreatic adenocarcinoma (n=24), followed by cholangiocarcinoma (n=11), gallbladder carcinoma (n=4), biliary compression by malignant nodes in the porta hepatis (n=4), and gastric (n=3), duodenal (n=2) and
ampullary carcinoma (n=2).
Histopathology revealed an
ampullary carcinoma infiltrating the superficial part of pancreas.
In conclusion, PDE is the treatment of choice not only for
ampullary carcinoma but also for adenoma with high grade dysplasia also for elderly persons in good somatical status; (3,17) for frail unfit persons (19) with distant metastases or miscellaneous contraindications for surgery remains endoscopic sphincterotomy and stenting a valide alternative of palliative treatment.
Some GIT causes of asymptomatic iron deficiency anaemia and prevalence as percentage of total Occult GI blood loss Common Aspirin/NSAID use 10-15% Colonic carcinoma 5-10% Gastric carcinoma 5% Benign gastric ulceration 5% Angiodysplasia 5% Uncommon Oesophagitis 2-4% Oesophageal carcinoma 1-2% Gastric antral vascular ectasia 1-2% Small-bowel tumours 1-2%
Ampullary carcinoma <1% Ancylomasta duodenale <1% Malabsorbtion Common Coeliac disease 4-6% Gastrectomy <5% H.
Is endosonography an effective method for detection and local staging of the
ampullary carcinoma? A prospective study.
Conclusion: in elderly patients, common bile duct stones often present atypically and co-existence with malignancy is not unusual;
ampullary carcinoma has a relatively good prognosis and ERCP is a safe and effective procedure in the management of biliary obstruction.
Gambill (33) found significant pancreatitis in 26 (10%) of 255 patients with pancreatic or
ampullary carcinoma. The presence of pancreatitis resultrd in a considerable delay in the diagnosis of carcinoma.