[Surgical treatment of tumors of the ampulla of Vater by local resection].

The cases of six patients suffering from Vater's ampulla neoplasia were studied 1981 and 1995. All cases are described both clinically and in terms of diagnostic techniques. All patients underwent a transduodenal excision of the neoplasia. A number of factors provided an indication for ampullectomy: the extremely high surgical risk, the suspected benign nature of the lesion or the very small size of the neoplasm associated with no pre-surgery finding of lymphadenomegaly in the area. The following issues were analysed: the accuracy of results obtained by a correct pre-surgery diagnosis, short and long term complications and mortality related to surgery. All patients received a five years post-surgery follow-up. Results show that the ampullectomy can be considered, in selected cases, as a valuable alternative to pancreatoduodenectomy even if further and wider studies are necessary in order to obtain an accurate definition of the correct pre-surgical diagnostic approach and surgical indications.