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Pancreatoduodenectomy for bile duct and ampullary cancer
Author(s) -
Yamaguchi Koji
Publication year - 2012
Publication title -
journal of hepato‐biliary‐pancreatic sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 1868-6974
DOI - 10.1007/s00534-011-0480-8
Subject(s) - medicine , bile duct cancer , bile duct , pancreaticoduodenectomy , lymph node , portal vein , dissection (medical) , pancreatic cancer , lymph , perineural invasion , radiology , resection , cancer , surgery , pathology
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.