Management of Periampullary Adenoma

Ian D. Norton, Christopher J. Gostout

Research output: Contribution to journalReview article

20 Scopus citations

Abstract

The periampullary region is the most common site of adenomatous change in the small bowel, particularly in patients with familial adenomatous polyposis (FAP) syndromes. These lesions have been shown to progress to malignancy in a manor analogous to colonic polyps. Following colectomy, the periampullary region is the commonest site of gastrointestinal malignancy in FAP patients. The periampullary region is within easy reach of forward- and side-viewing endoscopes and therefore endoscopic surveillance in FAP patients is both easy and prudent. Furthermore, there is accumulating evidence that endoscopic resection and/or ablation are the treatment of choice for periampullary adenomas. However, the optimal timing of surveillance and best methods of ablation remain to be determined. This paper reviews the literature on the endoscopic management of periampullary adenoma as well as outlining our current approach to this challenging problem.

Original languageEnglish (US)
Pages (from-to)266-273
Number of pages8
JournalDigestive Diseases
Volume16
Issue number5
DOIs
StatePublished - Jan 1999

Keywords

  • APC gene
  • Adenoma, surveillance
  • Ampulla of Vater
  • Endoscopy
  • Familial adenomatous polyposis

ASJC Scopus subject areas

  • Gastroenterology

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    Norton, I. D., & Gostout, C. J. (1999). Management of Periampullary Adenoma. Digestive Diseases, 16(5), 266-273. https://doi.org/10.1159/000016876