Vater papillary cancer

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 (VC) - 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 heart (with radical performance 5 years survival up to ½ pac.),
 * good results - because very soon it causes obstruction and symptoms.