Vater papillary cancer
From WikiLectures
Vater papilla carcinoma ( ampoule ) is a rarer tumor, it accounts for 1.5% of GIT tumors, it is mainly adenocarcinoma . It grows from the mucosa of the distal choledochus , pancreatic duct , own ampoules.
Clinical picture
- Painless jaundice (even intermittent) + picture of cholestasis,
- pancreatitis / cholangitis attacks ,
- epigastric pain with propagation to the back, diarrhea,
- symptoms of duodenal obstruction,
- liver enlarged, may be palpable gallbladder (Courvoisier's symptom),
- portae thrombosis + ascites formation .
Diagnostics
- Endoscopy with biopsy (loop),
- ERCP , PTC , USG ,
- laboratory: picture of cholestasis, ↑ AMS , jaundice may fluctuate, CA 19-9 .
Therapy
- Surgical - tumor resection + bile duct reconstruction (BC) - duodenopancreatectomy (Whipple's operation),
- in benign tumor, resection of the papilla with reimplantation of the bile duct, or and pancreatic duct.
Prognosis
- Better than in other tumors of the bile duct (with radical performance 5 years survival up to ½ pac.),
- good results - because very soon it causes obstruction and symptoms.
Links
References
- KLENER, P, et al. Internal Medicine. 3rd edition. Prague: Galén, 2006. ISBN 80-7262-430-X .
