“Preoperative assessment of underlying malignancy in non-FAP-related PAs requiring PD may be difficult, as endoscopic biopsy carries a false-negative rate as high as 50%. Although PD aims at preempting malignant transformation through complete removal of DA, it comes with significant morbidity and mortality risks. This is particularly relevant in patients with benign or premalignant pathology due to soft pancreatic parenchymal texture and small pancreatic duct diameter.”

“Our MRS is based on 4 preoperative factors associated with higher odds of malignancy in patients with non-FAP-related duodenal and ampullary adenoma requiring PD for complete eradication. This score can be used to assess the value of proceeding with PD by weighing the likelihood of having cancer against potential risk of complications after surgery. By using this scoring system, patients and clinicians can make more informed decisions regarding treatment approaches in the face of these challenging clinical decisions.”

Mavani, Parit T et al. “Multi-Institutional Analysis of Pancreaticoduodenectomy for Nonfamilial Periampullary Adenoma: A Novel Risk Score to Guide Shared Decision-Making.” Journal of the American College of Surgeons vol. 240,4 (2025): 392-402. Emory Users request article through ILLiad