Prise en charge endoscopique ou chirurgicale des lésions ampullaires.

Adenomas or adenocarcinomas of the ampulla are rare and mostly diagnosed fortuitously during an endoscopy performed for another indication. For a long time, surgical resection by pancreatic duodenectomy was the standard, at the cost of a significant morbidity and mortality. Transduodenal papillectomy is a less morbid surgical alternative. Nowadays, advances in interventional endoscopy allow a minimally invasive approach. Ampullary adenomas can be completely removed by endoscopic resection which should be the first treatment to propose. The risks of endoscopic papillectomy are dominated by acute pancreatitis and hemorrhage. This endoscopic technique could be proposed under certain conditions for localized adenocarcinomas without lymph node risk. The purpose of this review is to focus on the management of localized ampullary lesions that can benefit from endoscopic or surgical management. [ABSTRACT FROM AUTHOR]