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World J Gastrointest Endosc. Aug 16, 2010; 2(8): 278-287
Published online Aug 16, 2010. doi: 10.4253/wjge.v2.i8.278
Endoscopic ultrasound in the papilla and the periampullary region
Cecilia Castillo
Cecilia Castillo, Endoscopy Service, Latin American Endoscopy Training Center, Clínica Alemana de Santiago, Universidad del Desarrollo, Vitacura 5951, Santiago, Chile
Author contributions: Castillo C wrote the paper.
Correspondence to: Cecilia Castillo, MD, Endoscopy Service, Latin American Endoscopy Training Center, Clínica Alemana de Santiago, Universidad del Desarrollo, Vitacura 5951, Santiago, Chile. ccastillo@alemana.cl
Telephone: +56-2-5866032 Fax: +56-2-5866032
Received: March 1, 2010
Revised: June 22, 2010
Accepted: June 29, 2010
Published online: August 16, 2010
Abstract

Endoscopic ultrasound (EUS) provides relevant information when an ampullary or periampullary tumor is suspected. Early detection, T and N staging and Fine Needle Aspiration plus cithologic confirmation, are some of the expected benefits. Exclusion of benign findings like choledocholithiasis or chronic pancreatitis is also important. A correct understanding of the complex ampullary and periampullary anatomy is needed. Knowledge of the individual clinical history and other previous diagnostic images all contribute to a successful EUS examination. Radial and lineal EUS images are uniquely detailed and, at the moment, it seems to be the best way to exclude or confirm malignant or benign findings. We propose a procedural algorithm, including EUS, for suspected ampullary or periampullary tumors. This review summarizes the vast amount of information to be found spread in the literature, and recognizes this small anatomic area as the origin for a clinical entity with proper clinical presentation, proper imaging and proper therapeutic resolutions. The benefits of performing EUS for its study are highlighted.

Keywords: Endoscopic ultrasound; Periampullary region; Ampulla of Vater; Ampuloma; Pancreatic cancer