Background : Ampulla of Vater (AoV) cancer often presented with obstruction of bile flow, which required bile drainage. There are abundant lymphatic channels and microvascular structures around the ampulla of Vater (AoV), which spread out from the mucosal layer to the extramuscular layer, extended to the common channel, common bile duct and the main pancreatic duct. The aim of this study was to evaluate the association between preoperative endoscopic sphincterotomy (EST) and risk of lymph node metastasis and blood stream metastasis in patients with AoV cancer. Hence, this study aims to evaluate the oncologic effect of EST on overall survival and disease recurrence of AoV cancer.

Methods : We reviewed the medical records of 135 patients with AoV cancer who underwent pancreaticoduodenectomy from 2011 to 2020. We compared the perioperative outcomes, overall survival and disease recurrence of patients.

Results : 73 patients had endoscopic sphincterotomy for biliary drainage before surgery and the other 62 patients had no EST or percutaneous transhepatic biliary drainage. There were no significant differences in the 5-year overall survival rate (EST 68.1% vs. no EST 76%, p=0.909) and 5-year cumulative recurrence rate (EST 35.6% vs. no EST 40.3%, p=0.794).

Conclusions : The preoperative endoscopic intervention of the AoV cancer did not affect difference in oncologic outcome. Further evaluation on the interval affecting the oncologic outcome is needed in the future.