Article

Radical resection of biliary tract cancers and the role of extended lymphadenectomy.

Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
Surgical Oncology Clinics of North America (impact factor: 1.12). 05/2009; 18(2):339-59, ix. DOI:10.1016/j.soc.2008.12.011 pp.339-59, ix
Source: PubMed

ABSTRACT Extended hemihepatectomy and/or pancreatoduodenectomy plus extrahepatic bile duct resection and an extended lymphadenectomy of up to the group 2 lymph nodes can enable long-term survival in patients with extrahepatic bile duct (EBD) cancer with acceptable surgical risks. Surgeons should dissect and examine at least 10 or more nodes in curative intent surgeries for local disease control and accurate staging. Radical surgical procedures for EBD cancer, including a right lobectomy, left trisectoriectomy, hepatopancreatoduodenectomy, and combined vascular resection and reconstruction, are useful options for obtaining a negative margin, but the benefits of such procedures to long-term survival rates is limited to selected patients without nodal metastasis and with negative surgical margins.

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Keywords

acceptable surgical risks
 
curative intent surgeries
 
EBD
 
EBD cancer
 
extended lymphadenectomy
 
extrahepatic bile duct
 
extrahepatic bile duct resection
 
group 2 lymph nodes
 
hepatopancreatoduodenectomy
 
local disease control
 
long-term survival
 
long-term survival rates
 
negative margin
 
negative surgical margins
 
Radical surgical procedures
 

Yasuji Seyama