The clinical importance and role of transduodenal ampullectomy in a villous adenoma: A case report
Bibliographic record
Abstract
Ampullary adenoma is a precancerous lesion. Complete resection is required either endoscopically or surgically. We described a 64-year-old female patient with an ampullary adenoma, who was not suitable for endoscopic resection, so resection was performed by transduodenal ampullectomy. An ulcerated 16 mm × 13 mm hypoechoic ampullary polypoid lesion with high grade dysplasia and without infiltration into muscularis propria layer was reported on endosonographic examination. The electrocautery was used to resect the adenoma of ampulla. Bile and pancreatic ducts were approximated to duodenal wall via an absorbable suture (4-0 and 5-0 polydioxanone). No stent was used for bile and pancreatic ducts. Visualization of biliary and pancreatic drainages confirmed the patency of both ductal systems, which were 10 mm and 5 mm in diameters. Patient had no abnormalities related to biliary and pancreatic duct obstructions, and was discharged on postoperative day 8. Lesion had clear margins after transduodenal ampullectomy. In conclusion, although transduodenal ampullectomy (TDA) is technically demanding, our case is clinically important to demonstrate transduodenal ampullectomy is a safe alternative procedure to pancreaticoduodenectomy for adenoma of ampulla if the lesion is not suitable for endoscopic resection.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.004 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.006 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".