Ampullary adenoma.

Ampullary adenoma is a premalignant lesion involving the major papilla and surrounding mucosa of the second duodenum. These lesions may arise sporadically or in the setting of familial adenomatous polyposis syndrome. Ampullary adenoma may be found because of symptoms, at the time of adenomatous polyposis syndrome surveillance, or incidentally when upper endoscopy is performed for other reasons. Management options include observation, local or extended surgical resection (including pancreaticoduodenectomy), and endoscopic resection. Endoscopic resection is being performed more often and involves techniques similar to those of colonoscopic polypectomy. Preventing post-endoscopic resection pancreatitis is important and can be achieved with placement of temporary pancreatic duct stents.