Appropriate surgical management of periampullary adenocarcinoma (ampullary adenocarcinoma, duodenal adenocarcinoma, distal cholangiocarcinoma, and pancreatic head adenocarcinoma) requires a familiarity with both anatomy and cancer biology. This review describes the clinical behavior of the various subtypes of periampullary adenocarcinoma, the appropriate diagnostic evaluation of the patient afflicted with these malignancies, the surgical anatomy of the pancreas and peripancreatic region, and the nature and outcome of contemporary therapeutic interventions.
This review contains 9 figures, 7 tables, and 30 references.
Key words: American Joint Committee on Cancer staging system, ampullary adenocarcinoma, borderline resectable, distal cholangiocarcinoma, duodenal adenocarcinoma, locally advanced, pancreatic adenocarcinoma, superior mesenteric artery first dissection