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J Hepatobiliary Pancreat Sci. 2012 May;19(3):210-5. doi: 10.1007/s00534-011-0480-8.

Pancreatoduodenectomy for bile duct and ampullary cancer.

Author information

1
Department of Surgery 1, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan. yamaguch@med.uoeh-u.ac.jp

Abstract

Pylorus-preserving pancreatoduodenectomy has become a standard operation for distal and middle bile duct cancers. Bile duct cancer typically extends longitudinally and invades vertically. It frequently metastasizes to the lymph nodes and infiltrates the perineural spaces. The presence of residual cancer in the bile duct stump and lymph node metastases are significant prognostic factors. Negative surgical margins and D2 lymph node dissection are necessary for curative resection. The clinical course after portal vein resection for bile duct cancer with portal vein invasion is better than that of non-resectable bile duct cancer. Portal vein resection can therefore be useful. The efficacy of prophylactic portal vein resection is unclear. We describe here our methods for performing pylorus-preserving pancreatoduodenectomy for bile duct cancer.

PMID:
22170385
PMCID:
PMC3311854
DOI:
10.1007/s00534-011-0480-8
[Indexed for MEDLINE]
Free PMC Article
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