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World J Gastrointest Endosc. Dec 16, 2011; 3(12): 241-247
Published online Dec 16, 2011. doi: 10.4253/wjge.v3.i12.241
Diagnosis and management of ampullary adenoma: The expanding role of endoscopy
Payam Chini, Peter V Draganov
Payam Chini, Peter V Draganov, Division of Gastroenterology, Hepatology and Nutrition, University of Florida, Gainesville, FL 32610, United States
Author contributions: Chini P and Draganov PV have contributed equally.
Correspondence to: Peter V Draganov, MD, Division of Gastroenterology, Hepatology and Nutrition, University of Florida, 1600 SW Archer Road, PO Box 100214 Gainesville, FL 32610, United States. dragapv@medicine.ufl.edu
Telephone: +1-352-2739400 Fax: +1-352-3923618
Received: March 30, 2011
Revised: August 21, 2011
Accepted: August 28, 2011
Published online: December 16, 2011

Ampullary adenoma is a pre-cancerous lesion arising from the duodenal papilla that is often asymptomatic. It is important to distinguish whether the adenoma is sporadic or arises in the setting of familial adenomatous polyposis as this has important implications with respect to management and surveillance. Multiple modalities are available for staging of these lesions to help guide the most appropriate therapy. Those that are used most commonly include computed tomography, endoscopic ultrasound, and endoscopic retrograde cholangiopancreatography. In recent years, endoscopy has become the primary modality for therapeutic management of the majority of ampullary adenomas. Surgery remains the standard curative procedure for confirmed or suspected adenocarcinoma. This review will provide the framework for the diagnosis and management of ampullary adenomas from the perspective of the practicing gastroenterologist.

Keywords: Ampullary adenoma, Ampullectomy, Duodenal papilla, Familial adenomatous polyposis, Papillectomy