Treatment

Ampullary cancer treatment options may include:

• Surgery to remove the pancreas and small intestine. The Whipple procedure (pancreaticoduodenectomy) 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.

• Minimally invasive surgery. For very small ampullary cancers and precancerous tumors, it may be possible to remove the cancer with tools passed through an endoscope (endoscopic surgery). 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.

  Combined chemotherapy and radiation may be used before surgery, to make it more likely that a cancer can be removed completely during an operation. The combined treatment can also be used after surgery to kill any cancer cells that might remain.

• Chemotherapy alone. Chemotherapy is sometimes used after surgery to kill cancer cells that might remain. In people with advanced ampullary cancer, chemotherapy may be used alone to slow the growth of the cancer.
• Treatment to reduce pain and discomfort. If other treatments aren't possible or aren't helping, your doctor may recommend treatments that focus on making you feel more comfortable. This can include surgery to place a small wire mesh tube (stent) in your bile ducts to drain fluid that causes your skin and eyes to yellow.