Laparoscopic Transduodenal Ampullectomy: How We Have Standardized the Technique (with Video).
Journal
Annals of surgical oncology
ISSN: 1534-4681
Titre abrégé: Ann Surg Oncol
Pays: United States
ID NLM: 9420840
Informations de publication
Date de publication:
Feb 2023
Feb 2023
Historique:
received:
22
06
2022
accepted:
12
11
2022
pubmed:
13
12
2022
medline:
6
1
2023
entrez:
12
12
2022
Statut:
ppublish
Résumé
The procedure of choice for the resection of ampullary tumors comprises transduodenal ampullectomy (TDA), endoscopic papillectomy (EP), and pancreaticoduodenectomy (PD). A 48-year-old man was admitted to the hospital with epigastric pain. He had a history of cholecystolithiasis with chronic cholecystitis. A tumor approximately 2.2 cm in diameter located in the duodenal papilla was diagnosed by an enhanced computed tomography (CT) scan. The endoscopic biopsy result indicated a villous adenoma with moderate dysplasia. Laparoscopic TDA and cholecystectomy were planned. However, if the frozen sample analysis showed adenocarcinoma, laparoscopic PD (LPD) would be applied. The patient was placed in the supine position with both legs apart. Trocars were distributed in the same manner as in the authors' previous study to facilitate conversion to LPD. The operation time was 139 min, and the estimated blood loss was 50 ml. Final pathology confirmed villous adenoma with mild to moderate dysplasia. The postoperative course was uneventful, with a hospital stay of 9 days. There was no evidence of recurrence or patency of the reimplanted ducts 5 months after surgery. From February 2022 to May 2022, four cases of LTDA with the same surgical processes were managed by the authors, and all the patients recovered quickly without any postoperative complications. After standardization of the surgical processes, laparoscopic TDA was safe for highly selected patients. However, long-term follow-up is required to observe the quality of life and survival of patients.
Sections du résumé
BACKGROUND
BACKGROUND
The procedure of choice for the resection of ampullary tumors comprises transduodenal ampullectomy (TDA), endoscopic papillectomy (EP), and pancreaticoduodenectomy (PD).
METHODS
METHODS
A 48-year-old man was admitted to the hospital with epigastric pain. He had a history of cholecystolithiasis with chronic cholecystitis. A tumor approximately 2.2 cm in diameter located in the duodenal papilla was diagnosed by an enhanced computed tomography (CT) scan. The endoscopic biopsy result indicated a villous adenoma with moderate dysplasia. Laparoscopic TDA and cholecystectomy were planned. However, if the frozen sample analysis showed adenocarcinoma, laparoscopic PD (LPD) would be applied. The patient was placed in the supine position with both legs apart. Trocars were distributed in the same manner as in the authors' previous study to facilitate conversion to LPD.
RESULTS
RESULTS
The operation time was 139 min, and the estimated blood loss was 50 ml. Final pathology confirmed villous adenoma with mild to moderate dysplasia. The postoperative course was uneventful, with a hospital stay of 9 days. There was no evidence of recurrence or patency of the reimplanted ducts 5 months after surgery. From February 2022 to May 2022, four cases of LTDA with the same surgical processes were managed by the authors, and all the patients recovered quickly without any postoperative complications.
CONCLUSION
CONCLUSIONS
After standardization of the surgical processes, laparoscopic TDA was safe for highly selected patients. However, long-term follow-up is required to observe the quality of life and survival of patients.
Identifiants
pubmed: 36509879
doi: 10.1245/s10434-022-12867-5
pii: 10.1245/s10434-022-12867-5
doi:
Types de publication
Video-Audio Media
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1156-1157Subventions
Organisme : 1·3·5 project for disciplines of excellence-Clinical Research Incubation Project, West China Hospital, Sichuan University
ID : 18HXFH015
Organisme : National Institutes of Health of China
ID : W2017ZWS07
Informations de copyright
© 2022. Society of Surgical Oncology.
Références
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doi: 10.14701/ahbps.2021.25.1.150
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doi: 10.1007/s11605-014-2668-0
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doi: 10.1007/s00464-002-4548-z
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doi: 10.1007/s11605-022-05305-0
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doi: 10.1186/s12893-021-01414-w