Endoscopic ampullectomy

Ampullary tumors are rare tumors of the gastrointestinal tract. Compared with surgery, the endoscopic approach to remove these tumors by ampullectomy is associated with lower morbidity and mortality. Recent developments in endoscopic ultrasound, including intraductal ultrasound, have enabled accurate T staging of these tumors, and allowed the selection of appropriate candidates for endoscopic therapy. Currently, there is no standardization for the technique of endoscopic ampullectomy. In expert hands, endoscopic ampullectomy for benign adenomas leads to successful tumor eradication in more than 85% of patients. Regular endoscopic surveillance of the resected site is essential in all patients after ampullectomy, as tumor recurrence occurs in up to 20% of patients. This article reviews and discusses the indications for, and techniques and outcomes of, endoscopic ampullectomy.