Ampullary Adenocarcinoma - continued from the previous two slides. The ampullary tumor is marked by the arrow. Note the massively dilated common bile duct. Pancreatic tissue is above the dilated common bile duct. Duodenum is on the lower right. Majority of the ampullary adenocarcinomas are now treated by resection. With improvement in surgical techniques, the mortality and morbidity rates have come down significantly. Compared to the carcinoma of pancreas, carcinoma of the ampulla of Vater has a higher resectability rate and a better prognosis, although the long-term prognosis still remains poor. Favorable prognostic indicators include negative lymph node status and a moderately to well-differentiated tumor. Image courtesy of: Dr. Sanjay D. Deshmukh (Professor of Pathology) and Dr. Jayant M. Gadekar (Professor of Surgery), Dr. Vithalrao Vikhe Patil Foundation's Medical College & Hospitals, Ahmednagar, India.