ABSTRACT
Background: Ampullary and periampullary tumors are composed of a group of malignant and benign neoplasms arising in the region of the ampulla of Vater and are a major problem to the patients and surgeons and their management remains a big challenge
Objective: Study the age, sex distribution, presentation and management of patients with ampullary and periampullary tumors in Iraq and compare it with other world reports
Patients and Methods: prospective study of 50 patients with ampullary and periampullary tumors carried out in GIT hospital [tertiary center] from January 2013 to March 2015, risk factors, age, sex, clinical presentation, images study, diagnosis and modality of treatments whether curative or palliative are studied
Results: 29 [58%] were males and 21[42%] were females, about the age distribution the mean age was 45 ,about the residency they were mainly from Baghdad in [40%] the presenting symptom was obstructive jaundice in 43 [86%] ,duration of illness [range from 1-2 months] with the mean period 45 days, abdominal ultrasound study reveal distended Gallbladders in 76%, dilated CBD in 82%, dilated pancreatic duct in 56%, Hepatomegaly in 42%, dilated intrahepatic billiary tree in 64%, and liver secondary in 10%, resection surgery was done in 50%, palliative surgery in 12% and endoscopic palliation in 38%
Conclusion: Ampullary and periampullary tumors are relatively common. The mean age is 45 years, lower than the western studies. Sex: male are affected 1.4 times more than female with male: female ratio = 1.38 Abdominal ultrasound is very informative but EUS, CT scan and MRI, MRCP is the cornerstone for the diagnosis, Normal looking papilla does not rule out occult ampullary tumor