Definition and research guide
This page combines a MeSH definition, publication statistics and selected research abstracts. It is a starting point for reading the literature, not a medical textbook or a systematic evidence review.
Content available: 4 complete abstracts (1,035 words), 10 references. Full article text is not stored or reproduced here; follow the PMID, DOI or PMC links to read the original sources and their access terms.
Definition
A dilation of the duodenal papilla that is the opening of the juncture of the common bile duct and the main pancreatic duct, also known as the hepatopancreatic ampulla.
Definition: NLM Medical Subject Headings (MeSH) scope note (Public domain (U.S. National Library of Medicine); attribution requested). View the MeSH record.
Also known as: Vater Ampulla; Vater's Ampulla; Ampulla, Vater's; Vaters Ampulla; Hepatopancreatic Ampulla; Ampulla, Hepatopancreatic; Ampullas, Hepatopancreatic; Hepatopancreatic Ampullas.
Where it fits in the MeSH classification
- Broader topics
- Common Bile Duct; Duodenum; Pancreatic Ducts
- Narrower topics
- Sphincter of Oddi
- See also
- Cholangiopancreatography, Endoscopic Retrograde; Sphincterotomy, Transduodenal; Sphincterotomy, Endoscopic
Related concepts
- Common Bile Duct
- Main Pancreatic Duct
Research landscape
PubMed indexes 9,738 records tagged with the MeSH heading “Ampulla of Vater” (counts retrieved 2026-10-31). 806 of them (8.3%) were published from 2020 onward, and the busiest period so far is through 1999 with 5,913 records.
Reviews account for 846 records (8.7%) and meta-analyses for 62. Randomized controlled trials number 139 (1.4%) as a share of all records on the topic. Randomized trials make up only a small share of this literature, so much of what is known comes from laboratory, observational or descriptive work.
Show the data
| Period | Records |
|---|---|
| through 1999 | 5,913 |
| 2000-2009 | 1,529 |
| 2010-2019 | 1,490 |
| 2020 onward | 806 |
Publication-type chart data
| Type | Records | Share |
|---|---|---|
| Reviews | 846 | 8.7% |
| Meta-analyses | 62 | 0.6% |
| Randomized controlled trials | 139 | 1.4% |
Method: PubMed query "Ampulla of Vater"[MeSH Terms] with publication-type and date filters, retrieved 2026-10-31.
Reading the evidence in anatomy and physiology
Anatomy describes how body structures are built and physiology describes how they normally work, so most findings here are descriptive or mechanistic rather than evidence about treatment. Much of what is known comes from dissection, imaging, tissue studies and experiments in animals, and measurements in healthy volunteers can differ from those in people with disease or at different ages. Normal ranges vary between individuals and populations. Check whether a result was measured in people or in another species, the age and health of the participants, and the method used.
Evidence from open-access studies
These open-access studies come from PubMed’s best-match results for this heading (papers whose main topic it is), ranked here by citation count, with one recent addition. Each abstract is reproduced in full under its recorded open licence so that you can read the authors’ own words. They illustrate the literature; they are not a systematic summary of it. Citation counts measure attention, not reliability or clinical benefit.
| Study / authors | Year | Source label / design | Europe PMC citations | Licence / source |
|---|---|---|---|---|
| Therapeutic outcomes of endoscopic papillectomy for ampullary neoplasms: retrospective analysis of a multicenter study | 2017 | Research article Design not recorded in structured metadata | 58 | cc by PMID 28558658 · DOI · PMC5450406 |
| Upregulation of peroxisome proliferator-activated receptor-α and the lipid metabolism pathway promotes carcinogenesis of ampullary cancer | 2021 | Research article Design not recorded in structured metadata | 47 | cc by PMID 33390794 · DOI · PMC7738964 |
| Nomograms predict long-term survival for patients with periampullary adenocarcinoma after pancreatoduodenectomy | 2018 | Research article Design not recorded in structured metadata | 37 | cc by PMID 29580215 · DOI · PMC5870913 |
| Endoscopic papillectomy for ampullary adenomas in familial adenomatous polyposis | 2025 | Research article Design not recorded in structured metadata | 0 | cc by PMID 41186755 · DOI · PMC12586201 |
Therapeutic outcomes of endoscopic papillectomy for ampullary neoplasms: retrospective analysis of a multicenter study [1]
Abstract reading summary — source excerpts
- Opening excerpt
- BackgroundEndoscopic papillectomy (EP) is reported to be a relatively safe and reliable procedure for complete resection of ampullary neoplasms.
- Closing excerpt
- However, relatively high risk of procedure related complications is a problem that must be considered.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (326 words)
BackgroundEndoscopic papillectomy (EP) is reported to be a relatively safe and reliable procedure for complete resection of ampullary neoplasms. The aim of this study was to evaluate the therapeutic outcomes and complications of EP for ampullary neoplasms.MethodsA retrospective multicenter study was conducted with 5 participating centers from January 2007 to July 2014. A total of 104 patients who underwent EP for ampullary neoplasms were reviewed retrospectively. EP was performed by snare resection with or without submucosal lifting of the lesion.ResultsThe mean age of patients was 60.5 ± 12.1 years, and the male-to-female ratio was 2.0:1. En bloc resection was possible in 94 patients (90.3%). A biliary and a pancreatic stent were placed after EP in 42 patients and in 60 patients, respectively. A pathologically incomplete resection was noted in 11 cases (10.6%), and 5 of these patients were treated with additional endoscopic procedure. Histology of resected specimens was as follows: low grade adenoma (43.2%), high grade adenoma (14.4%), adenocarcinoma (16.3%), hyperplastic polyp (7.7%), and others (18.4%). Of the 75 cases with low grade adenoma on biopsy specimen, 21.3% turned out to have high grade adenoma (12%) or adenocarcinoma (9.3%). Procedure-related complications occurred in 33 patients (31.7%); bleeding (18 cases, 17.3%), pancreatitis (16 cases, 15.4%), and perforation (8 cases, 7.7%). Pre-EP ERCP, saline lifting, sphincterotomy, biliary stenting, pancreatic stenting, specimen size, and cauterization were not related to post EP complications. Surgery was performed in 6 cases with pathological incomplete resection and 2 cases with complications after EP, and there were 2 cases of mortality due to complications. During follow-up endoscopy after initial success of EP, remnant tumors were found in 7 patients, one of whom underwent surgery and the others were treated endoscopically. Consequently, the overall endoscopic success rate of EP was 89.4%.ConclusionsEndoscopic papillectomy appears to be an effective treatment for ampullary neoplasms, and can be considered as an alternative to surgery. However, relatively high risk of procedure related complications is a problem that must be considered.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 28558658 · DOI · PMC5450406
Upregulation of peroxisome proliferator-activated receptor-α and the lipid metabolism pathway promotes carcinogenesis of ampullary cancer [2]
Abstract reading summary — source excerpts
- Opening excerpt
- Ampullary cancer is a rare periampullary cancer currently with no targeted therapeutic agent.
- Closing excerpt
- Results from the CMap analysis suggested potential drugs for patients with ampullary cancer.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (298 words)
Ampullary cancer is a rare periampullary cancer currently with no targeted therapeutic agent. It is important to develop a deeper understanding of the carcinogenesis of ampullary cancer. We attempted to explore the characteristics of ampullary cancer in our dataset and a public database, followed by a search for potential drugs. We used a bioinformatics pipeline to analyze complementary (c)DNA microarray data of ampullary cancer and surrounding normal duodenal tissues from five patients. A public database from the National Center for Biotechnology Information Gene Expression Omnibus (NCBI GEO) was applied for external validation. Bioinformatics tools used included the Gene Set Enrichment Analysis (GSEA), Database for Annotation, Visualization and Integrated Discovery (DAVID), MetaCore, Kyoto Encyclopedia of Genes and Genomes (KEGG), Hallmark, BioCarta, Reactome, and Connectivity Map (CMap). In total, 9097 genes were upregulated in the five ampullary cancer samples compared to normal duodenal tissues. From the MetaCore analysis, genes of peroxisome proliferator-activated receptor alpha (PPARA) and retinoid X receptor (RXR)-regulated lipid metabolism were overexpressed in ampullary cancer tissues. Further a GSEA of the KEGG, Hallmark, Reactome, and Gene Ontology databases revealed that PPARA and lipid metabolism-related genes were enriched in our specimens of ampullary cancer and in the NCBI GSE39409 database. Expressions of PPARA messenger (m)RNA and the PPAR-α protein were higher in clinical samples and cell lines of ampullary cancer. US Food and Drug Administration (FDA)-approved drugs, including alvespimycin, trichostatin A (a histone deacetylase inhibitor), and cytochalasin B, may have novel therapeutic effects in ampullary cancer patients as predicted by the CMap analysis. Trichostatin A was the most potent agent for ampullary cancer with a half maximal inhibitory concentration of PPARA and lipid metabolism-related genes are potential pathways in the carcinogenesis and development of ampullary cancer. Results from the CMap analysis suggested potential drugs for patients with ampullary cancer.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 33390794 · DOI · PMC7738964
Nomograms predict long-term survival for patients with periampullary adenocarcinoma after pancreatoduodenectomy [3]
Abstract reading summary — source excerpts
- Opening excerpt
- BackgroundThe prognosis of patients with periampullary adenocarcinoma after pancreatoduodenectomy is diverse and not yet clearly illustrated.
- Closing excerpt
- ConclusionsThe present nomograms for OS and PFS prediction can provide valuable information for tailored decision-making for patients with periampullary adenocarcinoma after pancreatoduodenectomy.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (185 words)
BackgroundThe prognosis of patients with periampullary adenocarcinoma after pancreatoduodenectomy is diverse and not yet clearly illustrated. The aim of this study was to develop a nomogram to predict individual risk of overall survival (OS) and progression-free survival (PFS) in patients with periampullary adenocarcinoma after pancreatoduodenectomy.MethodsA total of 205 patients with periampullary adenocarcinoma after pancreatoduodenectomy were retrospectively included. OS and PFS were evaluated by the Kaplan-Meier method. Two nomograms for predicting OS and PFS were established, and the predictive accuracy was measured by the concordance index (Cindex) and calibration plots.ResultsLymph node ratio (LNR), carbohydrate antigen 19-9 (CA19-9) and anatomical location were incorporated into the nomogram for OS prediction and LNR, CA19-9; anatomical location and tumor differentiation were incorporated into the nomogram for PFS prediction. All calibration plots for the probability of OS and PFS fit well. The Cindexes of the nomograms for OS and PFS prediction were 0.678 and 0.68, respectively. The OS and PFS survival times were stratified significantly using the nomogram-predicted survival probabilities.ConclusionsThe present nomograms for OS and PFS prediction can provide valuable information for tailored decision-making for patients with periampullary adenocarcinoma after pancreatoduodenectomy.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 29580215 · DOI · PMC5870913
Endoscopic papillectomy for ampullary adenomas in familial adenomatous polyposis [4]
Abstract reading summary — source excerpts
- Opening excerpt
- Objectives of the study were to determine the success, complication and recurrence rate of endoscopic papillectomies in familial adenomatous polyposis (FAP) patients.
- Closing excerpt
- Adenoma recurrence can be successfully treated with a limited number of reinterventions.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (226 words)
Objectives of the study were to determine the success, complication and recurrence rate of endoscopic papillectomies in familial adenomatous polyposis (FAP) patients. Ampullary adenoma is frequent in familial adenomatous polyposis (FAP) patients. Endoscopic papillectomy is technically demanding for laterally spreading ampullary adenomas and bleeding, perforation and pancreatitis represent typical complications. 40 FAP patients undergoing endoscopic papillectomy were retrospectively analyzed. Data on periprocedural complications, histopathology, resection techniques and success were collected. Endoscopic papillectomy was performed in 21 male and 19 female patients. Mean adenoma size was 14 mm (8-40 mm). Additional mucosal resection was performed in 45%. Immediate and delayed bleeding occurred in 33% (n = 13) and 13% (n = 5), respectively. Bleeding was associated with male sex and pancreatic endoprosthesis. Endoscopically manageable perforation occurred in 2 patients. Acute pancreatitis occurred in 25% (n = 10) and was significantly associated with female sex. Histopathology revealed papillitis in 5% (n = 2), adenoma with low-grade dysplasia in 73% (n = 29), high-grade dysplasia in 13% (n = 5), and adenocarcinoma in 5% (n = 2). Cumulative recurrence-free resection was achieved in 94% (n = 33/35) after a mean of 1.4 procedures at a median follow-up of 591 days (range 15-2605). Endoscopic papillectomy shows a high clinical success in FAP patients even with laterally spreading adenoma. Adenoma recurrence can be successfully treated with a limited number of reinterventions.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 41186755 · DOI · PMC12586201
Key reviews and meta-analyses
The most cited review-type papers among PubMed’s best-match results for this heading, listed with bibliographic details only. Follow the links for the full text and access terms.
- Research article Papillary cannulation and sphincterotomy techniques at ERCP: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline [5]
- Research article Functional gallbladder and sphincter of oddi disorders [6]
- Research article A systematic review and meta-analysis of pylorus-preserving versus classical pancreaticoduodenectomy for surgical treatment of periampullary and pancreatic carcinoma [7]
- Research article Pathogenesis of carcinoma of the papilla of Vater [8]
- Research article The role of endoscopy in ampullary and duodenal adenomas [9]
- Research article Endoscopic management of ampullary tumors: European Society of Gastrointestinal Endoscopy (ESGE) Guideline [10]
References
- Kang SH, Kim KH, Kim TN, Jung MK, Cho CM, Cho KB, et al.. Therapeutic outcomes of endoscopic papillectomy for ampullary neoplasms: retrospective analysis of a multicenter study. . 2017. PMID 28558658 · DOI · PMC5450406
- Wang CY, Chao YJ, Chen YL, Wang TW, Phan NN, Hsu HP, et al.. Upregulation of peroxisome proliferator-activated receptor-α and the lipid metabolism pathway promotes carcinogenesis of ampullary cancer. . 2021. PMID 33390794 · DOI · PMC7738964
- He C, Mao Y, Wang J, Duan F, Lin X, Li S. Nomograms predict long-term survival for patients with periampullary adenocarcinoma after pancreatoduodenectomy. . 2018. PMID 29580215 · DOI · PMC5870913
- Wehling C, Eckstein Y, Stenzinger A, Ganion N, Bruckner T, Sauer P, et al.. Endoscopic papillectomy for ampullary adenomas in familial adenomatous polyposis. . 2025. PMID 41186755 · DOI · PMC12586201
- Testoni PA, Mariani A, Aabakken L, Arvanitakis M, Bories E, Costamagna G, et al.. Papillary cannulation and sphincterotomy techniques at ERCP: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline. Endoscopy. 2016. PMID 27299638 · DOI
- Behar J, Corazziari E, Guelrud M, Hogan W, Sherman S, Toouli J. Functional gallbladder and sphincter of oddi disorders. Gastroenterology. 2006. PMID 16678563 · DOI
- Diener MK, Knaebel HP, Heukaufer C, Antes G, Büchler MW, Seiler CM. A systematic review and meta-analysis of pylorus-preserving versus classical pancreaticoduodenectomy for surgical treatment of periampullary and pancreatic carcinoma. Ann Surg. 2007. PMID 17245171 · DOI
- Fischer HP, Zhou H. Pathogenesis of carcinoma of the papilla of Vater. J Hepatobiliary Pancreat Surg. 2004. PMID 15549428 · DOI
- ASGE Standards of Practice Committee, Chathadi KV, Khashab MA, Acosta RD, Chandrasekhara V, Eloubeidi MA, et al.. The role of endoscopy in ampullary and duodenal adenomas. Gastrointest Endosc. 2015. PMID 26260385 · DOI
- Vanbiervliet G, Strijker M, Arvanitakis M, Aelvoet A, Arnelo U, Beyna T, et al.. Endoscopic management of ampullary tumors: European Society of Gastrointestinal Endoscopy (ESGE) Guideline. Endoscopy. 2021. PMID 33728632 · DOI
About this article
- Sources
- NLM Medical Subject Headings (definition, synonyms); NCBI PubMed (counts, identifiers); Europe PMC (open-access abstracts and citation counts).
- Verification
- Every reference was resolved against PubMed on 2026-10-31; title, year and DOI matched.
- Review state
- automated source verified; no human expert review has been recorded yet.
- Version
- 1, last updated 2026-10-31.
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Evidence strength
EvidenceHelix's computed view of the study designs behind this topic: how common meta-analyses, randomized trials and reviews are, how recent the literature is, and a plain-language reading. It describes the design mix of the literature. It is not a quality appraisal of any study, and it is not medical advice.