eMedicine Specialties > Oncology > Carcinomas of the Gastrointestinal Tract

Carcinoma of the Ampulla of Vater: Multimedia

Author: Nafisa K Kuwajerwala, MD, Staff Surgeon, Breast Oncology, William Beaumont Hospital
Coauthor(s): Pankaj Chaturvedi, MBBS, MS, Associate Professor, Head and Neck Surgery, Department of Surgical Oncology, Tata Memorial Hospital, India; Ronald S Chamberlain, MD, Chairman, Chief, Department of Surgery, Saint Barnabas Medical Center; Venkata Subramanian Kanthimathinathan, MD, Staff Physician, Department of General Surgery, Loma Linda University Medical Center; Uma Chaturvedi, MD, MBBS, DPB, Lecturer, Department of Pathology, KJ Somaiya Hospital and Research Center, India; Gunateet Goswami, MD, Consulting Staff, Internal Medicine Associates, Mount Clemens, Michigan; Consulting Staff, Department of Cardiology, Henry Ford Hospital
Contributor Information and Disclosures

Updated: Apr 8, 2009

Multimedia

Endoscopic view of an ampullary carcinoma.Media file 1: Endoscopic view of an ampullary carcinoma.
Endoscopic view of an ampullary carcinoma.

Endoscopic view of an ampullary carcinoma.

Kocherization of the duodenum. For ampullary mali...Media file 2: Kocherization of the duodenum. For ampullary malignancies greater than 1 cm in size, pancreaticoduodenectomy is the preferred operation. This figure demonstrates the process of kocherization of the duodenum. The second and third portions of the duodenum are mobilized en bloc with the periduodenal nodal tissue. The authors prefer to expose the inferior vena cava (IVC) and remove alveolar tissue, which lies above the IVC en bloc with the specimen.
Kocherization of the duodenum. For ampullary mali...

Kocherization of the duodenum. For ampullary malignancies greater than 1 cm in size, pancreaticoduodenectomy is the preferred operation. This figure demonstrates the process of kocherization of the duodenum. The second and third portions of the duodenum are mobilized en bloc with the periduodenal nodal tissue. The authors prefer to expose the inferior vena cava (IVC) and remove alveolar tissue, which lies above the IVC en bloc with the specimen.

Periampullary malignancy. Transected pancreas wit...Media file 3: Periampullary malignancy. Transected pancreas with head. Pancreaticoduodenectomy is the preferred treatment for most periampullary tumors. This picture depicts transection of the pancreas at the pancreatic neck. This particular patient presented with a periampullary malignancy accompanied by jaundice and pancreatitis. A preoperative pancreatic stent (usually unnecessary) is seen within the pancreatic duct.
Periampullary malignancy. Transected pancreas wit...

Periampullary malignancy. Transected pancreas with head. Pancreaticoduodenectomy is the preferred treatment for most periampullary tumors. This picture depicts transection of the pancreas at the pancreatic neck. This particular patient presented with a periampullary malignancy accompanied by jaundice and pancreatitis. A preoperative pancreatic stent (usually unnecessary) is seen within the pancreatic duct.

Carcinoma of the ampulla of Vater. Roux-en-Y reco...Media file 4: Carcinoma of the ampulla of Vater. Roux-en-Y reconstruction following completion of a standard pancreaticoduodenectomy.
Carcinoma of the ampulla of Vater. Roux-en-Y reco...

Carcinoma of the ampulla of Vater. Roux-en-Y reconstruction following completion of a standard pancreaticoduodenectomy.

Double duct sign of periampullary cancers. Note t...Media file 5: Double duct sign of periampullary cancers. Note the dilated common bile duct as well as the pancreatic duct. Liver metastatic lesion is also seen.
Double duct sign of periampullary cancers. Note t...

Double duct sign of periampullary cancers. Note the dilated common bile duct as well as the pancreatic duct. Liver metastatic lesion is also seen.

Distended gall bladder with double duct sign in a...Media file 6: Distended gall bladder with double duct sign in a patient with periampullary cancer.
Distended gall bladder with double duct sign in a...

Distended gall bladder with double duct sign in a patient with periampullary cancer.

More on Carcinoma of the Ampulla of Vater

Overview: Carcinoma of the Ampulla of Vater
Differential Diagnoses & Workup: Carcinoma of the Ampulla of Vater
Treatment & Medication: Carcinoma of the Ampulla of Vater
Follow-up: Carcinoma of the Ampulla of Vater
Multimedia: Carcinoma of the Ampulla of Vater
References

References

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Further Reading

Keywords

periampullary carcinoma, periampullary malignancy, ampullary carcinoma, ampullary cancer, ampullary cancer treatment, ampullary cancer diagnosis, ampullary cancer symptoms, ampullary cancer pictures, carcinoma of papilla of Vater, adenocarcinomas, neuroendocrine tumors, cystadenomas, adenomas, adenocarcinoma of the ampulla of Vater, Courvoisier sign, familial adenomatous polyposis, FAP, duodenal adenomas, endoscopic ultrasonography, EUS, endoscopic retrograde cholangiopancreatography, ERCP, percutaneous transhepatic cholangiography, PTC, kocherization, pancreaticoduodenectomy, pylorus-preserving pancreaticoduodenectomy, transduodenal excision

Contributor Information and Disclosures

Author

Nafisa K Kuwajerwala, MD, Staff Surgeon, Breast Oncology, William Beaumont Hospital
Nafisa K Kuwajerwala, MD is a member of the following medical societies: American College of Surgeons
Disclosure: Nothing to disclose.

Coauthor(s)

Pankaj Chaturvedi, MBBS, MS, Associate Professor, Head and Neck Surgery, Department of Surgical Oncology, Tata Memorial Hospital, India
Pankaj Chaturvedi, MBBS, MS is a member of the following medical societies: American Association for the Advancement of Science and Association of Surgeons of India
Disclosure: Nothing to disclose.

Ronald S Chamberlain, MD, Chairman, Chief, Department of Surgery, Saint Barnabas Medical Center
Ronald S Chamberlain, MD is a member of the following medical societies: Alpha Omega Alpha, American Association for the Study of Liver Diseases, American College of Surgeons, American Medical Association, Phi Beta Kappa, Society for Surgery of the Alimentary Tract, and Society of Surgical Oncology
Disclosure: Nothing to disclose.

Venkata Subramanian Kanthimathinathan, MD, Staff Physician, Department of General Surgery, Loma Linda University Medical Center
Disclosure: Nothing to disclose.

Uma Chaturvedi, MD, MBBS, DPB, Lecturer, Department of Pathology, KJ Somaiya Hospital and Research Center, India
Disclosure: Nothing to disclose.

Gunateet Goswami, MD, Consulting Staff, Internal Medicine Associates, Mount Clemens, Michigan; Consulting Staff, Department of Cardiology, Henry Ford Hospital
Gunateet Goswami, MD is a member of the following medical societies: American Medical Association, American Society of Echocardiography, and Michigan State Medical Society
Disclosure: Nothing to disclose.

Medical Editor

Michael Perry, MD, MS, MACP, Nellie B Smith Chair of Oncology Emeritus, Professor, Department of Internal Medicine, Division of Hematology and Oncology, University of Missouri /Ellis Fischel Cancer Center
Michael Perry, MD, MS, MACP is a member of the following medical societies: Alpha Omega Alpha, American Association for Cancer Research, American College of Physicians, American College of Physicians-American Society of Internal Medicine, American Medical Association, American Society of Clinical Oncology, American Society of Hematology, International Association for the Study of Lung Cancer, and Missouri State Medical Association
Disclosure: Bionumerik Consulting fee Consulting; Proactya Consulting fee Consulting; GSK Consulting fee Consulting; NovoNordisk Consulting fee Consulting; Amgen Honoraria Speaking and teaching; GSK Consulting fee Speaking and teaching

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Benjamin Movsas, MD, Vice-Chairman, Department of Radiation Oncology, Fox Chase Cancer Center
Benjamin Movsas, MD is a member of the following medical societies: American College of Radiology, American Radium Society, and American Society for Therapeutic Radiology and Oncology
Disclosure: Nothing to disclose.

CME Editor

Rajalaxmi McKenna, MD, FACP, Consulting Staff, Department of Medicine, Southwest Medical Consultants, SC, Good Samaritan Hospital, Advocate Health Systems
Rajalaxmi McKenna, MD, FACP is a member of the following medical societies: American Society of Clinical Oncology, American Society of Hematology, and International Society on Thrombosis and Haemostasis
Disclosure: Nothing to disclose.

Chief Editor

Jules E Harris, MD, Clinical Professor of Medicine, Division of Hematology/Medical Oncology, Department of Internal Medicine, University of Arizona College of Medicine at Tucson; Consulting Staff, Arizona Cancer Center
Jules E Harris, MD is a member of the following medical societies: American Association for Cancer Research, American Association for the Advancement of Science, American Association of Immunologists, American Society of Hematology, and Central Society for Clinical Research
Disclosure: GlobeImmune Salary Consulting; Amplimed Consulting fee Consulting

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