Ampullary (AM-poo-la-ree) cancer is a rare cancer that forms in an area of your digestive system called the ampulla of Vater. The ampulla of Vater is where your bile duct and pancreatic duct join and empty into your small intestine.
Ampullary cancer forms near many other parts of the digestive system, such as the liver, pancreas and small intestine. When ampullary cancer grows, it may affect these other organs.
Ampullary cancer treatment often involves extensive surgery to remove the cancer and a large margin of healthy tissue.
- Teamwork. At Mayo Clinic, digestive disease specialists (gastroenterologists), oncologists, radiation oncologists, surgeons, pathologists and radiologists work as a multidisciplinary team to care for people with ampullary cancer. Other professionals are included as needed.
- Experience. Ampullary cancer is a rare type of cancer. Each year, Mayo Clinic specialists care for more than 400 people with ampullary cancer.
- Advanced diagnostic technology. Mayo Clinic doctors have access to the latest technology, including narrow band imaging endoscopy, to help diagnose and assess ampullary cancers.
- A full range of treatment options to consider. Mayo Clinic doctors will work with you to review all of your treatment options and choose the treatment that best suits your needs and goals. The range of treatments offered to people with ampullary cancer includes chemotherapy, radiation and several surgical procedures, such as the Whipple procedure, minimally invasive surgery and endoscopic surgery.
- Comprehensive cancer center. Mayo Clinic Cancer Center meets strict standards for a National Cancer Institute comprehensive cancer center, which recognizes scientific excellence and a multidisciplinary approach to cancer prevention, diagnosis and treatment.
Mayo Clinic in Rochester, Minn., Mayo Clinic in Jacksonville, Fla., and Mayo Clinic in Scottsdale, Ariz., are ranked among the Best Hospitals for cancer by U.S. News & World Report.
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Tests and procedures used to diagnose ampullary cancer include:
Passing a thin, flexible scope down your throat. Endoscopy is a procedure to examine your digestive system with a long, thin tube (endoscope) equipped with a tiny camera. The endoscope is passed down your throat, through your stomach and into your small intestine to view the ampulla of Vater.
Special surgical tools can be passed through the endoscope to collect a sample of suspicious tissue.
Endoscopy can also be used to create images. For instance, endoscopic ultrasound may help capture images of ampullary cancer.
Doctors also may inject a dye into your bile duct using endoscopy in a procedure called endoscopic retrograde cholangiopancreatography. The dye shows up on X-rays and can show blockages in your bile duct or pancreatic duct.
- Imaging tests. Imaging tests may help your doctor understand more about your cancer and determine whether it has spread beyond the ampulla of Vater. Imaging tests may include endscopic ultrasound, endoscopic retrograde cholangiopancreatography, magnetic resonance cholagniopancreatography and computerized tomography.
- Testing cancer cells in the laboratory. A sample of cancer cells removed during endoscopy or surgery can be analyzed in the lab to look for characteristics that might guide treatment.
Treatment for ampullary cancers typically involves surgery to remove the cancer.
Operations used to treat ampullary cancer include:
Surgery to remove the pancreas and small intestine. The Whipple procedure (pancreatoduodenectomy) involves removing the head of your pancreas, as well as a portion of your small intestine (duodenum), your gallbladder and part of your bile duct.
The Whipple procedure can be done using a large incision in your abdomen, or as a minimally invasive surgery, which uses several small incisions.
- Endoscopic surgery. For very small ampullary cancers and precancerous tumors, it may be possible to remove the cancer with tools passed through an endoscope. This may be an option in certain situations.
Other treatments that may be used for ampullary cancer include:
- Combined chemotherapy and radiation. Chemotherapy uses drugs to kill cancer cells. Radiation therapy uses beams of energy, such as X-rays, to kill cancer cells. Used together, these treatments may be more effective for ampullary cancers.
- Chemotherapy alone. In people with advanced ampullary cancer, chemotherapy may be used alone.
Mayo Clinic works with hundreds of insurance companies and is an in-network provider for millions of people. In most cases, Mayo Clinic doesn't require a physician referral. Some insurers require referrals or may have additional requirements for certain medical care. All appointments are prioritized on the basis of medical need.
At Mayo Clinic in Arizona, digestive disease specialists (gastroenterologists) work as a team with oncologists, surgeons, radiation oncologists, radiologists and pathologists to care for people with ampullary cancer.
For appointments or more information, call the Central Appointment Office at 800-446-2279 (toll-free) 8 a.m. to 5 p.m. Mountain Standard Time, Monday through Friday or complete an online appointment request form.
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At Mayo Clinic in Florida, digestive disease specialists (gastroenterologists) work as a team with oncologists, surgeons, radiation oncologists, radiologists and pathologists to care for people with ampullary cancer.
For appointments or more information, call the Central Appointment Office at 904-953-0853 8 a.m. to 5 p.m. Eastern time, Monday through Friday or complete an online appointment request form.
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At Mayo Clinic in Rochester, Minn., digestive disease specialists (gastroenterologists) work as a team with oncologists, surgeons, radiation oncologists, radiologists and pathologists to care for people with ampullary cancer.
For appointments or more information, call the Central Appointment Office at 507-538-3270 7 a.m. to 6 p.m. Central time, Monday through Friday or complete an online appointment request form.
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See information on patient services at the three Mayo Clinic locations, including transportation options and lodging.
Cancer research is conducted in coordination with the Mayo Clinic Cancer Center. The Mayo Clinic Cancer Center receives funding from the National Cancer Institute and is designated as a comprehensive cancer center — recognition for an institution's scientific excellence and multidisciplinary resources focused on cancer prevention, diagnosis and treatment.
See a list of publications by Mayo Clinic authors on ampullary cancer on PubMed, a service of the National Library of Medicine.
March 21, 2014
- Martin JA, et al. Ampullary carcinoma: Epidemiology, clinical manifestations, diagnosis and staging. http://www.uptodate.com/home. Accessed Oct. 22, 2013.
- Ryan DP, et al. Ampullary carcinoma: Treatment and prognosis. http://www.uptodate.com/home. Accessed Oct. 21, 2013.
- Golden AK. Decision Support System. Mayo Clinic, Rochester, Minn. Aug. 2, 2013.