No abstract available.
Ampulla of Vater* ; Duodenum ; Tuberculosis*

Ampulla of Vater (AoV) is a small dilated duct less than 1.5 cm long, formed by the union of pancreatic duct and common bile duct. AoV has also anatomic layer of mucosa, sphincter of Oddi, perisphincteric or duodenal submucosa, and duodenal proper muscle, which corresponds to mucosa, muscularis mucosa, submucosa, and proper muscle layer of other gastrointestinal tract organs, respectively. Because of its small compact size and variation of anatomic structure, it is sometimes difficult to identify layering architecture of AoV. This anatomic difficulty may cause some problem in T classification of ampullary carcinoma (AC). The most confusing point in T classification is the vague definition of T2, "Tumor invades duodenal wall". It seems that duodenal wall includes duodenal mucosa, submucosa, and proper muscle layer. However there is no precise description or definition about duodenal wall that might lead personal variation in T classification of AC staging. We found that clinical course of AC with perisphincteric and/or duodenal submucosal invasion is more close to AC with T2 than T1. Although it is described as T1b according to T classification scheme of ordinary gastrointestinal tract cancer, we thought AC with T1b may have more high-grade malignant potential than those of other gastrointestinal (GI) tract malignancy. AC showed various clinicopatholgic findings that represent heterogeneous tumor groups within category of AC. Recently site-specific classification of AC was introduced, and it showed relatively well-categorized clinical prognosis. It may be reasonable to understand site-specific tumorigenesis in AC. The standard gross protocol is needed to evaluate pathologic T classification of AC. In conclusion, ampullary neoplasm is composed of various subtypes, which require a separate approach according to anatomic epicenter of ampullary neoplasm. Although submucosal invasion in AC was classified into pT1b, its' biologic behavior is more close to pT2.
Ampulla of Vater ; Carcinogenesis ; Classification ; Common Bile Duct ; Duodenum ; Gastrointestinal Neoplasms ; Gastrointestinal Tract ; Humans ; Mucous Membrane ; Neoplasm Staging ; Pancreatic Ducts ; Prognosis ; Sphincter of Oddi

Percutaneous transhepatic intervention for removal of common bile duct stones is introduced as a secondary choice of treatment in the high-risk patient. Through a percutaneous transhepatic biliary drainage catheter, a Dormia basket was inserted and the stone was entraped. Then the stone was crushed and fragments were passed spontaneously to the duodenum through the Ampulla of Vater. We experienced one case of successful treatment of a common bile duct stone using percutaneous transhepatic insertion of the Dormia basket.
Ampulla of Vater ; Catheters ; Common Bile Duct ; Drainage ; Duodenum ; Humans

Percutaneous transhepatic intervention for removal of common bile duct stones is introduced as a secondary choice of treatment in the high-risk patient. Through a percutaneous transhepatic biliary drainage catheter, a Dormia basket was inserted and the stone was entraped. Then the stone was crushed and fragments were passed spontaneously to the duodenum through the Ampulla of Vater. We experienced one case of successful treatment of a common bile duct stone using percutaneous transhepatic insertion of the Dormia basket.
Ampulla of Vater ; Catheters ; Common Bile Duct ; Drainage ; Duodenum ; Humans

No abstract available.
Duodenum*

No abstract available.
Duodenum

No abstract available.
Duodenum

BACKGROUND/AIMS: The periampullary carcinoma includes the tumor originated from pancreatic head, distal bile duct, ampulla of Vater and duodenum. The survival and prognostic factors of these tumors after treatment were investigated according to the treatment modalities. METHODS: One hundred and sixty patients diagnosed as periampullary carcinoma from March, 1989 through November, 1996, were investigated to determine the clinical and pathological characteristics of periampullary carcinoma on the basis of medical records obtained by a retrograde method. The patients were divided into three groups such as pancreaticoduodenectomy group, bypass surgery group and percutaneous external drainage group. Their survival rates were analyzed according to the three different modalities of treatment and prognostic factors. RESULTS: The median survival was 24.6 months after pancreaticoduodenectomy, 9.6 months after bypass surgery, and 3.8 months after percutaneous external drainage. In univariate analysis of the survival according to the prognostic factors after radical pancreaticoduodenectomy, origin of the tumor, pathologic differentiation and sex appeared as significant prognostic factors. CONCLUSIONS: Radical pancreaticoduodenectomy for patients with periampullary carcinoma is crucial for better survival. If the patient is fit to endure the operation and the extent of tumor invasion is limited, pancreaticoduodenectomy is the best choice of treatment.
Ampulla of Vater ; Bile Ducts ; Drainage ; Duodenum ; Head ; Humans ; Medical Records ; Pancreaticoduodenectomy ; Survival Analysis* ; Survival Rate

Dieulafoy's lesion is an uncommon but important cause of massive upper gastrointestinal bleeding. The lesion usually occurs in the lesser curvature of the stomach within 6 cm of the gastroesophageal junction but extragastric locations of Dieulafoy's lesion are rare. In this study, diagnosis of Dieulafoy's lesion was frequently made by endoscopy instead of surgery. Hemostasis was achieved by endoscopic treatment in more than 90% of patients. We report the successful application of endoscopic hemoclipping for treatment of active bleeding from Dieulafoy's lesion in the ampulla of Vater of the duodenum.
Ampulla of Vater* ; Diagnosis ; Duodenum ; Endoscopy ; Esophagogastric Junction ; Hemorrhage ; Hemostasis ; Humans ; Stomach

Gangliocytic paraganglioma is a rare and benign gastrointestinal tumor that usually arises in the second portion of the duodenum. Histogenesis of this tumor is yet unclear. It is incidentally found during radiographic examinations or during endoscopy looking for the cause of gastrointestinal hemorrhage, which usually manifests as mucosal ulcerations. To our knowledge, there was only one case of duodenal gangliocytic paraganglioma presenting with melena in Korea. We experienced a case of gangliocytic paraganglioma arising from the ampulla of Vater, presenting as obstructive jaundice, which was subsequently removed surgically. Thus, we report this case with a review of literatures.
Ampulla of Vater* ; Duodenum ; Endoscopy ; Gastrointestinal Hemorrhage ; Jaundice* ; Jaundice, Obstructive ; Korea ; Melena ; Paraganglioma* ; Ulcer