Carcinoma of the papilla of Vater following treatment ofpancreaticobiliary maljunction

Watanabe, Masato; Midorikawa, Yutaka; Yamano, Toshihisa; Mushiake, Hajime; Fukuda, Naoto; Kirita, Takashi; Mizuguchi, Kunio; Sugiyama, Yasuyuki

doi:10.3748/wjg.15.6126

Cited by 6 publications

(9 citation statements)

References 12 publications

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“…Four out of 5 (age at the cut-off of 70, lymph-nodes metastases, microvascular invasion and pancreatobiliary subtype) independent prognosticators revealed in our study are well known and described in numerous publications [2,[8][9][10][27][28][29] . However, we disclosed PEBD to be one of the most decisive negative prognosticators of long-term outcome in resected ampullary carcinoma (HR 3.92).…”

Section: Discussionmentioning

confidence: 80%

Preoperative Endoscopic Biliary Drainage May Negatively Impact Survival Following Pancreatoduodenectomy for Ampullary Cancer

Barauskas

Urbonas²,

Smailytė³

et al. 2016

Dig Surg

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Background/Aims: Ampullary carcinoma is a rare tumour with a high resectability rate. There is an increasing body of evidence indicating not only tumour-related factors, but also jaundice influence survival following curative resection. Several modalities for preoperative biliary drainage are available; however, routine preoperative endoscopic biliary drainage (PEBD) is not recommended. There is no sufficient data regarding the impact of PEBD on long-term outcomes. The aim of our study was to identify predictive factors of survival with special regard to PEBD in patients undergoing curative resection for ampullary carcinoma. Patients and Methods: Data from 64 consecutive patients with adenocarcinoma of the papilla of Vater who have been operated on was analysed. Overall survival was defined from the date of surgery to the date of death, or censored at the last patient contact. Survival analysis was determined by means of the Kaplan-Meier method. The significance of the demographic, clinical and histopathologic factors was ascertained by the log-rank test. A Cox proportional hazard model was used to determine independent prognostic factors of survival. Results: Twenty patients (31.2%) underwent PEBD. Univariate analysis revealed tumour-related factors, age over 70, and PEBD to negatively influence survival. Five of them (excluding T stage) were identified as the independent prognosticators, while PEBD appeared to be the most decisive factor. Median survival for patients who underwent PEBD was 25.3 months as compared to 112.9 months for those who did not. In conclusion, PEBD negatively affected long-term outcomes in our patients with resected ampullary carcinoma.

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Section: Discussionmentioning

confidence: 80%

Preoperative Endoscopic Biliary Drainage May Negatively Impact Survival Following Pancreatoduodenectomy for Ampullary Cancer

Barauskas

Urbonas²,

Smailytė³

et al. 2016

Dig Surg

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“…The estimated incidence of cancer development after a diversion operation is 0.7%, and the interval between the operation and cancer detection ranges from 1 to 19 years [ 9 ]. The development of carcinoma of the papilla of Vater after choledochojejunostomy for PBM is rare; only 1 such report has been published [ 4 ]. No reports have discussed the risk factors for carcinoma of the papilla of Vater or the relationship between PBM and carcinoma of the papilla of Vater.…”

Section: Discussionmentioning

confidence: 99%

“…If a tumor at the common channel develops alongside the papilla of Vater, the tumor may manifest as a carcinoma of the papilla of Vater. Careful postoperative examination is important for patients who have undergone a diversion operation for PBM because jaundice is not usually observed in patients who have undergone a diversion operation of the bile duct, although it is one of the most common manifestations of carcinoma of the papilla of Vater [ 4 ]. In the present case, the patient had undergone regular follow-up CT examinations.…”

Section: Discussionmentioning

confidence: 99%

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Carcinoma of the Papilla of Vater after Diversion Operation for Pancreaticobiliary Maljunction

Yamanaka

Araki

Ishii

et al. 2017

Case Rep Gastroenterol

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Pancreaticobiliary maljunction (PBM) is a congenital malformation that is associated with biliary cancer development. When patients are diagnosed with PBM, a diversion operation is recommended. Although a risk remains for developing residual bile duct carcinoma following diversion, the development of a carcinoma of the ampulla of Vater after a diversion operation for PBM is rare. We present a treated case of carcinoma of the ampulla of Vater after a diversion operation for PBM. A 65-year-old woman presented with abdominal pain. She had undergone extrahepatic bile duct resection and cholecystectomy 2 years 9 months previously for the treatment of type Ic PBM according to the Todani classification. At the current admission for evaluation of the abdominal pain, computed tomography and magnetic resonance imaging showed only dilation of the main pancreatic duct. However, gastrointestinal endoscopy showed a tumor at the papilla of Vater, and biopsy revealed adenocarcinoma of the papilla of Vater. We performed pylorus-preserving pancreaticoduodenectomy, and the pathological diagnosis was moderately differentiated tubular adenocarcinoma of the papilla of Vater with no metastasis to the lymph nodes. The patient remained in good health for 3 years postoperatively. Carcinoma of the papilla of Vater after a diversion operation for PBM is rare. In this case, a diagnosis could not be made by computed tomography or magnetic resonance imaging; the definitive diagnosis was obtained with gastrointestinal endoscopy. Careful postoperative follow-up with gastrointestinal endoscopy in addition to imaging examination may be needed after a diversion operation for PBM.

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“…New complications may also occur later, such as narrow anastomosis, reflux cholangitis, intra-hepatic duct stones, and bile duct tumors. There are some PBM patients with obstructive jaundice or acute pancreatitis or other diseases[ 45 , 46 ]. The operation of these patients is considered to increase the postoperative risk.…”

Section: Treatment Of Pbmmentioning

confidence: 99%

Application of imaging techniques in pancreaticobiliary maljunction

Wang¹,

Mu²,

Xu³

et al. 2022

WJCC

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Imaging techniques are useful tools in the diagnosis and treatment of pancreaticobiliary maljunction (PBM). PBM is a precancerous lesion often relative to the disease of the pancreas and biliary tract, for example, cholecystolithiasis, protein plugs, and pancreatitis. For patients with PBM, early diagnosis and timely treatment are highly important, which is largely dependent on imaging techniques. The continuous development of imaging techniques, including endoscopic retrograde cholangiopancreatography, magnetic resonance cholangiopancreatography, computed tomography, ultrasound, and intraoperative cholangiography, has provided appropriate diagnostic and therapeutic tools for PBM. Imaging techniques, including non-invasive and invasive, have distinct advantages and disadvantages. The purpose of this paper is to review the application of various imaging techniques in the diagnosis and treatment of PBM.

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Carcinoma of the papilla of Vater following treatment ofpancreaticobiliary maljunction

Cited by 6 publications

References 12 publications

Preoperative Endoscopic Biliary Drainage May Negatively Impact Survival Following Pancreatoduodenectomy for Ampullary Cancer

Preoperative Endoscopic Biliary Drainage May Negatively Impact Survival Following Pancreatoduodenectomy for Ampullary Cancer

Carcinoma of the Papilla of Vater after Diversion Operation for Pancreaticobiliary Maljunction

Application of imaging techniques in pancreaticobiliary maljunction

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