Ampullary cancer care at Mayo Clinic

Mayo Clinic doctors are experienced in diagnosing and treating rare cancers, such as ampullary cancer. Each year, more than 100 people with ampullary cancer receive care at Mayo Clinic.

Diagnosis at Mayo Clinic

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 endoscopic ultrasound, endoscopic retrograde cholangiopancreatography, magnetic resonance cholangiopancreatography 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 and prognosis.

Treatment at Mayo Clinic

Ampullary cancer treatment options may 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.
  • Combined chemotherapy and radiation. Chemotherapy uses drugs to kill cancer cells. Radiation therapy uses beams of energy, such as X-rays and protons, 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.
Feb. 16, 2017
References
  1. Townsend CM Jr, et al. Tumors of the bile ducts, gallbladder and ampulla. In: Sabiston Textbook of Surgery: The Biological Basis of Modern Surgical Practice. 19th ed. Philadelphia, Pa.: Saunders Elsevier; 2012. https://www.clinicalkey.com. Accessed Oct. 27, 2016.
  2. Ryan DP, et al. Ampullary carcinoma: Treatment and prognosis. http://www.uptodate.com/home. Accessed Oct. 27, 2016.
  3. Riggin ER. Allscripts EPSi. Mayo Clinic, Rochester, Minn. July 29, 2016.