Background: Transduodenal ampullectomy (TDA) is performed for early cancer of the ampulla of Vater (AoV). This study aimed to analyze the short- and long-term outcomes of TDA. Methods: Patients who underwent TDA performed for AoV malignancy with carcinoma in-situ (Tis) and T1 stage from August 2017 to February 2025 were reviewed. Results: Twenty-eight patients with malignant tumors underwent TDA. The mean operation time was 118.6 ± 36.8 min. The median estimated blood loss was 60 (0-700)ml. The median length of hospital stays was 9 (6-22) days. The mean overall complication rate was 14.3 % with postoperative pancreatic fistula was 17.9%. Lymph node metastasis rates were 20%. The overall survival (OS) and disease-free survival (DFS) rate were 52.4 and 51.2 months, respectively. Conclusion: TDA accompanied with lymph node dissection was advisable in Tis and T1 AoV cancers in view of superior perioperative outcomes and similar long-term survival rates.

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