You could start with either calling the pancreatic cancer groups like pancan and asking if they have heard of anyone thought of as an expert, also search for pancreatic cancer specialists as some will have more ampullary patients. I would also search for NCI comprehensive centers by state and make a lot of calls fast. If one or two areas in liver and small you may find a surgeon that could be talked into removing them, if in peritoneum search words HIPEC, if in lung sometimes if small doc might be willing to remove them but if in nodes and another area not sure beyond chemo what one might offer, and could search for trials. If was intestinal tissue type is one class of drugs and if pancreatic tissue type might be another class of drugs, goal then treatment/remission. Good luck. Many top centers have gastrointestinal cancer specialists, try to get to top doc at one of those, when calling ask number of ampullary cancer patients, recurrence,...