Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2021 Sep;92(9):771-775.
doi: 10.1007/s00104-021-01452-3. Epub 2021 Jul 15.

[Preoperative diagnostics in periampullary adenocarcinomas]

[Article in German]
Ulrich Friedrich Wellner  1 , Louisa Bolm  1 , Miljana Vladimirov  2 , Tobias Keck  3
Affiliations
Review

[Preoperative diagnostics in periampullary adenocarcinomas]

[Article in German]
Ulrich Friedrich Wellner et al. Chirurg. 2021 Sep.

Abstract
in English, German

Background: Approximately 30-40% of pancreatoduodenectomies for adenocarcinomas result in nonpancreatic periampullary adenocarcinoma as the final diagnosis. Depending on the origin, a distinction is made between four different carcinomas with histomorphological subtypes.

Objective: Carcinoma location and subtype are of prognostic and therapeutic relevance; however, the preoperative differentiation is often incorrect despite modern diagnostics.

Material and methods: Overview of the current literature on the classification and preoperative diagnostics of periampullary adenocarcinomas.

Results: A precise knowledge of the papillary anatomy is necessary for the correct classification of diagnostic findings. Current studies demonstrate diagnostically valuable information from the anamnesis, imaging and endoscopy.

Conclusion: In ca. 70-80% of cases a correct diagnosis of the type of periampullary adenocarcinoma is possible on the basis of interdisciplinary diagnostics. This potentially enables a correspondingly individualized treatment planning in the preoperative phase.

Zusammenfassung: HINTERGRUND: Etwa 30–40 % der Pankreatoduodenektomien wegen Adenokarzinomen ergeben in der endgültigen Diagnostik nichtpankreane periampulläre Adenokarzinome. Je nach Ursprung unterscheidet man vier verschiedene Karzinome mit histomorphologischen Subtypen.

Fragestellung: Karzinomlokalisation und Subtyp sind von prognostischer und therapeutischer Relevanz. Die präoperative Differenzierung ist jedoch trotz moderner Diagnostik oft nicht korrekt.

Material und methoden: Übersicht über die aktuelle Literatur zur Klassifikation und präoperativen Diagnostik periampullärer Adenokarzinome.

Ergebnisse: Zur korrekten Einordnung diagnostischer Befunde ist eine genaue Kenntnis der papillären Anatomie notwendig. Aktuelle Studien demonstrieren diagnostisch wertvolle Hinweise aus Anamnese, Bildgebung und Endoskopie.

Schlussfolgerungen: In ca. 70–80 % der Fälle ist eine korrekte Artdiagnose der periampullären Adenokarzinome auf Basis der interdisziplinären Diagnostik möglich. Dies ermöglicht potenziell eine entsprechend individualisierte Therapieplanung bereits präoperativ.

Keywords: Ampullary carcinoma; Distal cholangiocarcinoma; Duodenal carcinoma; Pancreatic head carcinoma; Pancreatoduodenectomy.

PubMed Disclaimer

References

Literatur

    1. Adam R, Chiche L, Aloia T et al (2006) Hepatic resection for noncolorectal nonendocrine liver metastases: analysis of 1,452 patients and development of a prognostic model. Ann Surg 244:524–535. https://doi.org/10.1097/01.sla.0000239036.46827.5f - DOI - PubMed - PMC
    1. Adler G, Seufferlein T, Bischoff SC et al (2007) S3-Guidelines „Exocrine pancreatic cancer“ 2007. Z Gastroenterol 45:487–523 - DOI - PubMed
    1. Albores-Saavedra J, Henson DE, Klimstra DS (2000) Tumors of the gallbladder, extrahepatic bile ducts, and ampulla of vater, 3. Aufl. Armed Forces Institute of Pathology, Washington DC
    1. Ang DC, Shia J, Tang LH et al (2014) The utility of immunohistochemistry in subtyping adenocarcinoma of the ampulla of vater. Am J Surg Pathol 38:1371–1379. https://doi.org/10.1097/PAS.0000000000000230 - DOI - PubMed
    1. Asbun HJ, Conlon K, Fernandez-Cruz L et al (2014) When to perform a pancreatoduodenectomy in the absence of positive histology? A consensus statement by the International Study Group of Pancreatic Surgery. Surgery 155:887–892. https://doi.org/10.1016/j.surg.2013.12.032 - DOI - PubMed

MeSH terms

LinkOut - more resources