An unexpected diagnosis

John Davis wasn’t expecting the diagnosis. A two-time cancer survivor, he never imagined he’d be sitting in a doctor’s office again, being told they had found a pre-cancerous growth that needed to be removed.

“I was very surprised that they found the tumor,” says Davis, 63. “I didn’t expect them to find anything.”

Although he had no symptoms other than anemia, an upper endoscopy showed that Davis had a pre-cancerous growth on his duodenum, located in the second portion of the small intestine, called the ampulla, which plays an important role in digestion as both common bile duct and pancreatic duct empty here. This pre-cancerous growth was a large ampullary adenoma.

A Whipple operation is a traditional surgical method to remove a tumor the size of Davis’s on the duodenum. It involves removing the part of the pancreas that’s next to the duodenum, the duodenum itself, part of the bile duct and sometimes, part of the stomach. While it would remove the entire lesion, it’s a major operation with a long recovery time and the potential for complications. Davis wasn’t looking forward to having this surgery, and he began looking for alternative options.

“I was really dreading the Whipple procedure, and when another option became available, I was very anxious and happy to have another choice,” says Davis.

Davis’s gastroenterologist, Dr. Everett Kirch, referred him to Dr. Kenneth Chi, a gastroenterologist affiliated with Advocate Lutheran General Hospital in Park Ridge, Ill., who was able to remove the tumor endoscopically through a procedure called an Endoscopic Ampullectomy. Through this minimally-invasive endoscopic procedure, Dr. Chi removed the entire abnormal tissue piece by piece through the camera without the need for surgery.

“Through a series of injections using a saline mixture, the abnormal tissue was able to be carefully “lifted up” to provide extra “cushion” to be able to safely remove the tissue using a snare and cautery, so that the muscle underneath was left intact,” says Dr. Chi.

The endoscopic procedure was performed in October 2017, and due to its minimally-invasive nature, Davis was able to go home the same day. A few weeks later, the stent that was placed in Davis’s pancreatic duct to protect the pancreas from becoming inflamed after the procedure was removed.

Today, he is feeling well and has made a full recovery. Doctors recently biopsied the tissue surrounding where the tumor had been, and everything was clear. Recent bloodwork showed that he was no longer anemic. Davis is back to work and the hobbies he enjoys including ice fishing, carpentry, gardening and watching his grandsons’ hockey games.

“I’m very thankful to Dr. Chi and all the staff,” says Davis.