Related Experiment Videos
Patterns of lymph node metastasis in carcinoma of the distal bile duct
T Yoshida1, K Shibata, H Yokoyama
1Department of Surgery I, Oita Medical University, Japan.
Background/Aims:
The aim of this study was to clarify the lymphatic spread in distal bile duct carcinoma in relation to local tumor extent (pT category).
Methodology:
The distribution and number of involved nodes were examined in 42 patients with distal bile duct cancer.
Results:
Lymph node metastases were present in 25 of 42 patients (60%); 5 of 12 (42%) with pT2 tumors and 20 of 26 (77%) with pT3 tumors. Nodal involvement was not identified in 4 patients with pT1 tumors. The incidence of node positivity was higher in patients with pT3 tumors than in those with pT1 or pT2 tumors (p<0.01 or p<0.05). The total number of positive nodes was greater in patients with pT3 tumors than in those with pT2 tumors (mean: 3.08 vs. 0.75; p<0.01). All node-positive patients had involved nodes in the hepatoduodenal ligament or posterior pancreaticoduodenal region, or both. The number of positive nodes in the superior mesenteric and para-aortic region was greater in patients with pT3 tumors than in those with pT2 tumors (p<0.05).
Conclusions:
As tumor invades the pancreas from the distal bile duct, lymphatic spread extends from the hepatoduodenal ligament or posterior pancreaticoduodenal region to the superior mesenteric and para-aortic nodes.