Resident UT Southwestern Medical Center Richardson, Texas, United States
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
Participants should be aware of the following financial/non-financial relationships:
Amr I. Al Abbas, MD: I do not have any relevant financial / non-financial relationships with any proprietary interests.
Introduction: We have a case of a 58 year-old patient who presented with an incidentally discovered ampullary adenoma. Multiple endoscopists recommended surgical resection as it was not amenable to endoscopic resection. After appropriate work-up, they were taken to the operating room for resection.
Methods:
Results: The patient did well postoperatively. There were no complications. Pathology showed an adenoma without dysplasia. They were discharged postoperative day six. They had no complaints at follow-up and there was no recurrence on repeat endoscopy at one and two years.
Conclusions: Robotic transduodenal ampullectomy is safe and feasible in select patients with non-invasive adenomas not amenable to endoscopic resection. Bile duct identification is facilitated by trans-cystic catheter insertion and ultrasound. It is necessary to have routine endoscopic surveillance to rule out recurrence.
Learning Objectives:
Upon completion, participant will be able to articulate the steps of a transduodenal ampullectomy robotically
Upon completion, participant will be able to appreciate the utility of IV secretin
Upon completion, participant will be able to appreciate the utility of intraoperative ultrasound
