Confused about Surgery for a Neuroendocrine Tumor

I was diagnosed with a lowgrade neuroendocrine tumor lat the ampulla.It's ~1.2 cm and is partially obstructing the bile duct.  I'm in pain most of the time and they have finally put me on pain meds and nerve pills. This diagnosis has been a process that has taken several months.  

I saw a local surgeon this week and he recommends doing a local excision and sphincteroplasty. I can't find much information on this operation. The way he described the surgery, he will open me up somewhat with the same incision as a whipple procedure. He said he will remove my gall bladder, cut into the duodenum, locate and remove the tumor, check the lymph nodes and remove any that seem problematic, insert a stent and feeding tube and then close me up.  All in 2 1/2 hours.  He was pretty proud of that time! He said I would be in the hospital for 6 - 10 days and I would recover pretty quickly!

I'm a healthy and active 54 year old female. I want to ensure that the surgery I end up having is curative. I don't want to spend the rest of my life worrying about a reoccurence and ending up with more and more surgeries.

I'm pretty overwhelmed and exhausted. Does the surgery  described sound like an appropriate surgery for this type of problem? Or should I start looking at the bigger facilities like Johns Hopkins or Mayo Clinic (Rochester, Mn).

Any guidance would be greatly appreciated.

[S. Kaul, MD]

Hi there!

To begin with it should be made sure that the tumour is not present else where in the body. If the site you mention is the only one involved; then the surgery, well explained by your doctor is likely the correct procedure and additional therapies may be indicated depending on the type of tumor. The surgery is intricate and needs to be done carefully and 2 ½ would indeed be a rather quick time for this. The hospital stay after the first 2-3 days is just to make sure that no complications occur. The surgery would ‘most likely’ be curative since even with the best treatment, no one can guarantee the tumour would not recur or be found at some other site. In your situation I would suggest going ahead with the treatment suggested by you doctor, but make sure that the doctor has enough experience in dealing with these type of surgeries or else you may look at the university based/ teaching hospitals or obtain a second opinion.
Hope this is helpful.

Take care!