BACKGROUND:

Disinsertion of the ampulla of Vater is a serious but rare event during gastric resection.
Injury to this area is possible during any operation on the duodenum, but occurs most frequently in the presence of scarring or inflammation that causes secondary shortening of the duodenal bulb. Endoscopic papillectomy is a “high risk” procedure: the reported complication rate varying from 8% to 35%, with acute pancreatitis the most common complication (5%–15%) ; however, disinsertion of the ampulla of Vater has not been reported in the literature after endoscopic
papillectomy. We present the first report of a patient developing papillary disinsertion after
endoscopic papillectomy for a papillary neuroendocrine tumor. Completion pancreaticoduodenectomy was necessary and patient recover uneventfully.