Pancreas, Duodenum, Ampulla of Vater and Extrahepatic Bile Ducts

  • Derek C. Allen
  • R. Iain Cameron
  • Maurice B. Loughrey


This chapter outlines the anatomy, clinical presentation, and relevant clinical investigations. Details of both non-neoplastic and neoplastic pathological conditions affecting this organ site are given. Clinical considerations in obtaining the diagnostic biopsy and therapeutic resection specimens are outlined, with details of their handling and dissection in the histopathology laboratory. This is correlated with relevant histopathology reports, giving summary core prognostic and patient management items. Current WHO and TNM classifications are referenced.


Bile Duct Acute Pancreatitis Common Bile Duct Chronic Pancreatitis Pancreatic Duct 


  1. Albores-Saavedra J, Henson DE, Klimstra DS. Tumors of the gallbladder, extrahepatic bile ducts and ampulla of vater, Atlas of tumor pathology, vol. 3rd series. Fascicle 27. Washington: AFIP; 2000.Google Scholar
  2. Allen DC, Cameron RI. Histopathology specimens: clinical, pathological and laboratory aspects. 1st ed. Berlin/Heidelberg: Springer; 2004.Google Scholar
  3. Beckingham IJ, editor. ABC of liver, pancreas and gall bladder diseases. London: BMJ Books; 2001.Google Scholar
  4. Bosman FT, Carneiro F. WHO classification of tumours of the digestive system. 4th ed. Lyon: IARC Press; 2010.Google Scholar
  5. Carter D, Russell RCG, Pitt HA, Bismuth H, editors. Rob and Smith’s operative surgery: hepatobiliary and pancreatic surgery. 5th ed. London: Chapman and Hall; 1996.Google Scholar
  6. Day DW, Jass JR, Price AB, Shepherd NA, Sloan JM, Talbot IC, Warren BF, Williams GT. Morson and Dawson’s gastrointestinal pathology. 4th ed. Oxford: Blackwell Science; 2003.CrossRefGoogle Scholar
  7. Hruban RH, Pitman MB, Klimstra DS. Tumors of the pancreas, Atlas of tumor pathology, vol. 4th series. Fascicle 6. Washington: AFIP; 2007.Google Scholar
  8. Odze RD, Goldblum JR. Surgical pathology of the GI tract, liver, biliary tract and pancreas. 2nd ed. Philadelphia: Saunders/Elsevier; 2009.Google Scholar
  9. The Royal College of Pathologists. Cancer datasets (oesophageal carcinoma, gastric carcinoma, carcinomas of the pancreas, ampulla of vater and common bile duct, colorectal cancer, gastrointestinal stromal tumours (GISTs), liver resection specimens and liver biopsies for primary and metastatic carcinoma, endocrine tumours of the gastrointestinal tract including pancreas) and tissue pathways (gastrointestinal and pancreatobiliary pathology, liver biopsies for the investigation of medical disease and for focal liver lesions). Accessed at Accussed on December 2011.
  10. Verbeke CS. Resection margins and R1 rates in pancreatic cancer – are we there yet? Histopathology. 2008;52:787–96.PubMedCrossRefGoogle Scholar
  11. Verbeke CS. Endocrine tumours of the pancreas. Histopathology. 2010;56:669–82.PubMedCrossRefGoogle Scholar
  12. Wittekind C, Greene L, Hutter RVP, Klimfinger M, Sobin LH. TNM atlas: illustrated guide to the TNM/pTNM classification of malignant tumours. 5th ed. Berlin/Heidelberg: Springer; 2005.Google Scholar

Copyright information

© Springer-Verlag London 2013

Authors and Affiliations

  • Derek C. Allen
    • 1
  • R. Iain Cameron
    • 2
  • Maurice B. Loughrey
    • 3
  1. 1.Histopathology LaboratoryBelfast City Hospital, Belfast Health and Social Care TrustBelfastUK
  2. 2.Histopathology LaboratoryAltnagelvin Hospital, Western Health and Social Care TrustLondonderryUK
  3. 3.Histopathology LaboratoryInstitute of Pathology, Royal Victoria Hospital, Belfast Health and Social Care TrustBelfastUK

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