DIAGNOSIS OF CARCINOMA OF AMPULLA VATER WITH SCRAPING PROCEDURE OF DISTAL COMMON BILE DUCT / 中国普通外科杂志

ABSTRACT

The scraping procedure was adopted in 13 cases for diagnosis.of tumors of the ampulla vater. 11 of the 13 cases obtained tissue from distal common bile duct. Histological diagnoses included 9 adenocarcinoma, one adenoma with high atypical hyperplasia and carcinoma in situ,one villous papilomatous hyperplasia. No tissue obtained in two patients who were suspected to have ampullary carcinoma preoperatively. Adoptation of this method routinely during exploration of common bile duct would help diagnose the neglected carcinoma of ampulla vater. Most patients with malignancy of ampulla vater would obtain a positive result. However,a negative result could not rule out the diagnosis and other diagnostic tools should be used. If the tissues scraped were diagnosed as adenoma or villous tumor histologically, the malignant change might have been missed. Complete excision of the ampullary lesion is required to assess the presence or absence of malignancy accurately.