Related Experiment Video
Updated: Jun 24, 2026
Treatment of Middle-segment Pancreatic Benign Tumor Using Laparoscopic Central Pancreatectomy with End-to-end Pancreatic Duct Reconstruction
Published on: January 2, 2026
Bile duct segmental resection versus pancreaticoduodenectomy for middle-third extrahepatic cholangiocarcinoma: A
Su Hyung Park1, Ji Su Kim2, Yeon Su Kim3
1Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea.
Backgrounds/Aims:
The optimal surgical approach for middle-third extrahepatic cholangiocarcinoma (MCC)-bile duct segmental resection (BDSR) or pancreaticoduodenectomy (PD)-remains controversial. This study aimed to compare the short- and long-term outcomes of BDSR and PD in patients with MCC.
Methods:
We retrospectively analyzed 570 patients who underwent curative-intent surgery for MCC between January 2010 and December 2022. Clinicopathological characteristics, surgical outcomes, and oncologic outcomes (progression-free survival [PFS] and overall survival [OS]) were compared after 1:3 propensity score matching.
Results:
Among 570 patients, 112 underwent BDSR and 458 PD. After propensity score matching, BDSR showed shorter operative time and hospital stay (both p < 0.001), but fewer retrieved lymph nodes and higher local recurrence rates (both p < 0.001). PFS was inferior after BDSR (27.4 vs. 34.3 months, p = 0.004), whereas OS was comparable (36.7 vs. 55.5 months, p = 0.117). In patients with R0 resection, both PFS and OS were similar between groups.
Conclusions:
BDSR may offer perioperative advantages over PD, but is associated with inferior PFS, with no significant difference in OS. In patients who achieved R0 resection, the PFS and OS did not reach statistical significance. This suggests that BDSR should be considered only in highly selected patients in whom R0 resection is achievable.
