A Patient with Duodenal Adenoma which was Resected Papilla of Vater and Duodenal Mucosa

Nobuhiko Ueda, Hideaki Nezuka, Seiichi Yamamoto and Yoshiaki Isobe

Department of Surgery, Maizuru Kyosai Hospital

A patient with duodenal adenoma underwent papilla of Vater and duodenal mucosa resection. A 60-year-old woman was found by endoscopy to have an elevated lesion cerebrally situated from the oral side of the papilla of Vater to the transitional point to the third portion of the papilla about a quarter. The lesion surface was white, finely granular, and soft, but malignant findings were not seen. Biopsy showed adenoma with moderate dysplasia and surgery was conducted due to possible cancer complication. The tumor was found surgically to be limited to the mucosal layer and the margin was clear. The tumor was resected from the normal duodenal mucosa keeping a margin 5 to 10mm in diameter. After papillectomy with confirmation of the tumor extent, the bile duct and pancreatic duct were reconstructed. Pathologically, the tumor was tubulovillous adenoma with mild to moderate dysplasia limited to the mucosal layer without cancerous lesions. The patient has been followed up for 1.5 years without evidence of recurrence, cholangitis, or pancreatitis.

Key words
duodenal adenoma, tubulo-villous adenoma, papillectomy

Reprint requests
Nobuhiko Ueda Department of Surgery, Maizuru Kyosai Hospital 1035 Hama, Aza, Maizuru, 625-8585 JAPAN

Accepted
June 26, 2001

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