XXXX of the ampulla of Vater.

@entity1 @entity788 @entity5 @entity189 @entity3 @entity652 @entity420
Thirty-five consecutive cases of @entity420 of the ampulla of Vater seen over the past 36 years were reviewed. The introduction of new diagnostic techniques over the course of this study improved the accuracy of preoperative diagnosis but did not lead to earlier diagnosis. The surgical resectability rate was 88%, and 53% of postoperative survivors were free of disease at 5 years. Of the 14 @entity1 with @entity3 to regional lymph nodes, 27% survived disease-free for 5 years. Surgical mortality was 25% for the entire series but has been reduced to 6.6% over the past decade. Surgical mortality was primarily due to leakage of the pancreaticojejunostomy; the risk of pancreaticojejunostomy leak correlated inversely with the degree of chronic @entity788 in the pancreatic remnant. In 35% of resected cases, a benign adenomatous component was contained within the @entity5 of the ampulla of Vater. Cure rates are good for this lesion. The most important factor in maximizing cure rate is careful attention to the technical details of pancreaticojejunostomy in order to minimize surgical mortality. Benign @entity652 appear to be a frequent precursor of @entity189 of the ampulla of Vater.
