The Duodenum’s Ampulla of Vater is a mound-like opening. The duodenum is a C-shaped bowel loop at the start of the intestine. It is the junction of the bile duct, which transports bile from the liver, and the pancreatic duct, which transports pancreatic juice from the pancreas, before opening into the intestine. Cancer that occurs around the ampulla of Vater is referred to as periampullary cancer. Cancers of the head of the pancreas, the distal bile duct (cholangiocarcinoma), the duodenum, and the ampulla are among them. According to the onco surgeon in Kolkata, these cancers are grouped together because their clinical characteristics and treatments are similar. They’re all adenocarcinomas, but their prognosis differs.
Types Of Periampullary Cancer
As listed by the surgical oncologist in Kolkata, periampullary cancer are of the following types:
- Pancreatic Cancer: It all starts in the pancreas tissues with uncontrolled cell formation. Pancreatic cancer has a tendency to spread quickly.
- Distal Bile Duct Cancer: The lining of the lowermost portion of the bile duct, where this cancer, also known as cholangiocarcinoma, passes through the pancreas, enters the pancreatic duct, and ends in the intestine.
- Duodenal Cancer: It comes from the mucosa lining of the duodenum. Food from the stomach is combined with bile and pancreatic juice in the duodenum. The majority of duodenal cancers start in the duodenum’s second part, where the ampulla is located.
- Ampullary Cancer: The lining of the Ampulla of Vater is the place where ampullary cancer occurs.
Symptoms Of Periampullary Cancer
Periampullary cancers compress the bile duct, obstructing the flow of bile and causing jaundice (yellowing of the eyes and urine). Pale stools and itching are also experienced. Weight loss, loss of appetite, and abdominal pain are also warning signs of periampullary cancer. Furthermore, cancers of the duodenum and Ampulla of Vater cause bleeding, which results in black stools (melena) and anaemia, says the cancer specialist in Kolkata.
Periampullary Cancer Treatment Modalities in Kolkata
Treatment is determined by the stage of the cancer and the severity of the jaundice. Surgery is the safest treatment that should be considered if the cancer is discovered at a point where it can be fully removed. If your jaundice is serious, the best cancer surgeon in Kolkata may treat it with endoscopic retrograde cholangiopancreatography (ERCP) and stenting before surgery.
If your tumour is advanced, he can recommend neoadjuvant treatment (chemotherapy or chemoradiotherapy) to shrink the tumour before resecting it to lessen the risks.
An effort is made to downstage unresectable tumours to a stage where they can be surgically removed. Neoadjuvant therapy is given, and some of these patients will be able to undergo surgery.
Surgical Removal Of Periampullary Cancer
The Whipple operation, also known as pancreaticoduodenectomy, is a surgical procedure used to remove periampullary cancer. The head of the pancreas, in addition to the duodenum, bile duct, gall bladder, a portion of the liver, a small portion of the small intestine, and neighbouring lymph nodes, are removed in this procedure.