How is management of periampullary adenoma?

Result From endoscopic biopsy Mx of small Tu. (2cm or less) Local Excision if no malignancy EUS : Help in eva. of Duodenal invasion Endoscopic / Transduodenal excision : 2-3 mm margin If post-op. Patho. Reveal Invasive cancer Reop. For Whipple FAP Even patho =Duodenal Adenoma High recurrence rate & High CA Op. of choice = Standard (not PPPD) Whipple