{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T23:00:18Z","timestamp":1740178818054,"version":"3.37.3"},"reference-count":14,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2017,7,20]],"date-time":"2017-07-20T00:00:00Z","timestamp":1500508800000},"content-version":"vor","delay-in-days":49,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Annals of Gastroent Surgery"],"published-print":{"date-parts":[[2017,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Surgical resection for distal cholangiocarcinoma is usually carried out using pancreaticoduodenectomy (<jats:styled-content style=\"fixed-case\">PD<\/jats:styled-content>). However, because <jats:styled-content style=\"fixed-case\">PD<\/jats:styled-content> is a complex procedure with a high rate of postoperative complications, the surgical indications should be carefully considered, especially for patients with a decreased performance status, significant comorbidities, and\/or anatomical anomalies. If curatively carried out, a less invasive, local resection may be an alternative procedure for such patients. In the current study, we present pancreas\u2010preserving resection of the lower biliary tract in a patient with early\u2010stage distal cholangiocarcinoma. This procedure was selected to avoid <jats:styled-content style=\"fixed-case\">PD<\/jats:styled-content> with arterial reconstruction because of arterial anomalies. After an abdominal exploration, a cholecystectomy was carried out and the common hepatic duct was transected. The bile duct was dissected from the pancreatic parenchyma without pancreatic resection, downward to the biliopancreatic ductal confluence. Next, a duodenotomy was done opposite Vater's ampulla. The duodenal mucosa around Vater's ampulla was incised and dissected, and the main pancreatic duct (<jats:styled-content style=\"fixed-case\">MPD<\/jats:styled-content>) was divided. The bile duct was completely separated from the pancreatic parenchyma, and the lower biliary tract was totally \u201ccored\u2010out\u201d. After resection, the <jats:styled-content style=\"fixed-case\">MPD<\/jats:styled-content> was re\u2010implanted into the duodenal wall, and the duodenotomy was closed. Finally, a Roux\u2010en\u2010Y hepaticojejunostomy was created. Postoperative course was uneventful. No tumor recurrence has been observed for 21 months after the operation. Thus, pancreas\u2010preserving resection of the lower biliary tract appeared to be appropriate for our patient. This organ\u2010preserving approach can be a useful, alternative procedure in selected patients.<\/jats:p>","DOI":"10.1002\/ags3.12021","type":"journal-article","created":{"date-parts":[[2017,7,20]],"date-time":"2017-07-20T09:09:20Z","timestamp":1500541760000},"page":"150-155","source":"Crossref","is-referenced-by-count":2,"title":["Pancreas\u2010preserving resection of lower biliary tract adenocarcinoma: A coring\u2010out technique"],"prefix":"10.1002","volume":"1","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3660-612X","authenticated-orcid":false,"given":"Yasunori","family":"Nishida","sequence":"first","affiliation":[{"name":"Department of Hepatobiliary and Pancreatic Surgery National Cancer Center Hospital East Kashiwa Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Motokazu","family":"Sugimoto","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary and Pancreatic Surgery National Cancer Center Hospital East Kashiwa Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Motohiro","family":"Kojima","sequence":"additional","affiliation":[{"name":"Division of Pathology Research Center for Innovative Oncology National Cancer Center Hospital East Kashiwa Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naoto","family":"Gotohda","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary and Pancreatic Surgery National Cancer Center Hospital East Kashiwa Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masaru","family":"Konishi","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary and Pancreatic Surgery National Cancer Center Hospital East Kashiwa Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shinichiro","family":"Takahashi","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary and Pancreatic Surgery National Cancer Center Hospital East Kashiwa Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,7,20]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0168-8278(02)00297-0"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-010-1325-4"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2004.10.008"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2009.02.023"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.9752"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000000263"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/hpb.12063"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11605-013-2320-4"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.semdp.2012.08.010"},{"key":"e_1_2_6_11_1","first-page":"1255","article-title":"Pancreas\u2010preserving biliary amputation with pancreatic diversion: a new surgical technique for complete resection of the intrapancreatic biliary system","volume":"51","author":"Kondo S","year":"2004","journal-title":"Hepatogastroenterology"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00534-008-0013-2"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/jso.21089"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00534-010-0308-y"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11605-016-3179-y"}],"container-title":["Annals of Gastroenterological Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fags3.12021","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ags3.12021","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,5]],"date-time":"2023-10-05T22:33:43Z","timestamp":1696545223000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ags3.12021"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,6]]},"references-count":14,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2017,6]]}},"alternative-id":["10.1002\/ags3.12021"],"URL":"https:\/\/doi.org\/10.1002\/ags3.12021","archive":["Portico"],"relation":{},"ISSN":["2475-0328","2475-0328"],"issn-type":[{"type":"print","value":"2475-0328"},{"type":"electronic","value":"2475-0328"}],"subject":[],"published":{"date-parts":[[2017,6]]}}}