Tumor of Vater's ampulla – What is the right management?

Introduction: The adenoma-carcinoma sequence is well-known at tumors of Vater papilla, too. These could be removed endoscopically or surgically with ampullectomy or partial pancreatoduodenectomy. Case report: A 53 years old male patient was admitted to the hospital with painless jaundice. The abdominal ultrasound examination revealed dilatation of the extra- and intrahepatic bile ducts. ERCP showed a 7mm in diameter filling defect in the suprapapillary area. After papillotomy a villous polyp protruded into the lumen at the lower surface of orifice. It was endoscopically removed and sent for histological evaluati…