Periampullary Cancer

Periampullary Cancer

Periampullary cancer is a cancer that forms near the ampulla of Vater, an enlargement of the ducts from the liver and pancreas where they join and enter the small intestine

What Are the Symptoms of Periampullary Cancer?

  • Loss of appetite and weight loss.
  • Abdominal (belly) pain.
  • Back pain.
  • Pruritus, or skin itchiness, associated with the jaundice.
  • Stomach upset and vomiting.
  • Diarrhea
  • Gastrointestinal bleeding.
  • Pancreatitis (inflammation of the pancreas)


  • Patients with familial adenomatous polyposis have an increased risk of suffering from ampullary cancer. The incidence is higher in patients who have inflammatory bowel disease.
  • At the chromosomal level, loss of alleles of chromosome 17p and 18q are associated with ampullary cancer (55% and 36%)
  • Other factors like cigarette smoking and diabetes mellitus may be associated with ampullary cancer.


Treatment for ampullary cancer is usually with surgery to remove the cancer. For very small cancers, surgical tools can be passed down the throat, through the stomach, and into the small intestine to cut away the cancer. A larger cancer might require more extensive surgery to remove the cancer, the gallbladder, and portions of the bile duct, pancreas, and small intestine. Chemotherapy with powerful drugs and radiation with energy beams might also be options.


To diagnose ampullary cancer, the doctor passes a long thin tube equipped with a camera down the throat, through the stomach, and into the small intestine. The camera is used to look for signs of cancer in the ampulla of Vater, which is the area where ducts leading from the liver and pancreas connect to the small intestine. Special tools passed through the tube can collect a sample of cells for testing. Imaging tests like CT, MRI, and ultrasound might also be used.

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