**3.10 Changes in the gallbladder**

In the case of the vaterian ampullomas, changes of the gallbladder can also occur, namely, in volume, wall, as well as the presence of calcifications inside (**Figure 11**).

The changes of the gallbladder are detected by computed tomography or magnetic resonance in 33% of occurrences in the case of the vaterian ampullomas, but without being able to distinguish if they were preexisting or caused by neoplasia [1].

Comparing to primitive duodenal neoplasms, there are no changes to the cholecyst.

It is considered that over 60% of the changes of the gallbladder in the tumor pathology of the duodenopancreatic region are detected in the cases of neoplasms of the ampulla of Vater. This leads to the conclusion that the presence of a gap in the periampullary region associated with changes in the choledochal caliber and with changes in the cholecyst leads the diagnosis to a vaterian ampulloma.

It is considered that there are no intracholecystic tumor masses and that the presence of vesicular lithiasis predominated in the case of the vaterian ampullomas.

In the case of ampullary carcinomas, there is no analysis of the changes of the vessels, due to their nonexistence, taking into account the anatomical reports of the ampulla of Vater.
