[Principles and value of lymph node excision in tumors of the pancreatobiliary system]

Malignancies of the gallbladder, bile ducts and pancreas have a very bad prognosis compared with other gastrointestinal malignomas. Lymph node metastasis has frequently been identified as an important prognostic factor. This leads to some surgeons to embark on an extremely aggressive resectional strategy, including wide lymphadenectomy. So far, reported results of these procedures have varied considerably and concomitant morbidity has often exceeded that of standard resections. Until there is unequivocal proof of the benefit of an extended lymphadenectomy in controlled studies this strategy cannot be recommended generally.