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Know more about Ampullary Carcinoma
Definition of Ampullary Carcinoma
Ampullary Carcinoma is a type of cancer, that occurs in a specialized area of your digestive tract, the Ampulla of Vater. The ampulla is where the bile duct and pancreatic duct join to open into the duodenum – the initial segment of small intestine. Thus ampullary cancer can arise from any of the tissues of the bile duct, pancreatic duct or the duodenum and accordingly the behavior of these cancers varies based on the tissue of origin.
Causes of Ampullary Cancer
These are the following reasons, by which this particular cancer is formed in your body
Symptoms of Ampullary Cancer
Some of the common symptoms seen in patients with ampullary cancer include
Diagnosis
Apart from a thorough history and physical examination, following tests may need to be done in a patient with suspected ampullary cancer. They include
Blood tests
Blood tests will reveal anemia due to blood loss, and will show abnormalities like elevated Bilirubin – marker of jaundice and increased levels of enzymes related to the liver like SGOT, SGPT and ALP. A marker of pancreatic or bile duct cancer is a protein named CA 19.9 which may be elevated in most cases
Imaging tests
Common imaging tests that a physician uses to diagnose ampullary cancer include – USG abdomen, CT scan abdomen and MRI. These tests will provide information regarding the size of the tumour. They will also let your physician know if the disease is early or fairly advanced and whether any surgical cure is possible.
Endoscopic Ultrasound and Biopsy
This is again an endoscopic procedure, where in your physician passes a long tube down your throat, and it traverses to the part of your gut – the duodenum. This tube is fitted with a camera and mini ultrasound probe at its tip, thus can help in proper visualization of the area of involvement by the cancer and local extent of the disease. This is Endoscopic Ultrasound scan. A needle or forceps can simultaneously be used to take biopsies from suspicious areas.
Treatment options
Surgery is the primary option, for you to get rid of ampullary cancer.Whipple’s procedure – This major surgery involves removal of the head of the pancreas along with the adjacent duodenum, lower aspect of bile duct, a portion of stomach and surrounding lymph nodes. The remaining structures are reconstructed back.Ampullectomy – This procedure usually reserved for elderly patients involves removal of the ampulla only and is done if the tumour is in early stages.The physician may consider using plastic stents to relieve jaundice if tumour is fairly advanced or to relieve jaundice temporarily before surgery.Chemotherapy or Radiation therapy may also be used after surgery or before surgery depending on the stage and size of the tumour .
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