{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T11:15:28Z","timestamp":1761822928562},"reference-count":26,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[1997,7,1]],"date-time":"1997-07-01T00:00:00Z","timestamp":867715200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1997,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>The pattern of lymphatic spread of ampullary cancer is poorly documented. This pattern was clarified in order to define the rational extent of radical lymphadenectomy.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Method<\/jats:title>\n                  <jats:p>Thirty-nine consecutive patients who underwent pancreaticoduodenectomy with radical lymphadenectomy were included in the study. A total of 1447 lymph nodes dissected from the resected specimens was examined to detect the presence of metastatic foci.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Twenty-one of the 39 patients had a total of 97 positive nodes. The sites of nodal involvement were the posterior pancreaticoduodenal (20 of 21 patients), inferior pancreaticoduodenal artery (IPDA; 12 of 21), anterior pancreaticoduodenal (three of 21), trunk of the superior mesenteric artery (three of 20), pericholedochal (three of 21), retroportal (two of 21), and para-aortic (three of five) regions. No metastases were found in the hepatic artery, cystic duct, perigastric, right coeliac, middle colic artery or right caval node groups.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Ampullary cancer mainly spreads to the posterior pancreaticoduodenal node group, then to the IPDA node group, and finally to the para-aortic area. The rational extent of radical lymphadenectomy should include the pancreaticoduodenal, superior mesenteric, pericholedochal, retroportal and para-aortic nodes.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1002\/bjs.1800840734","type":"journal-article","created":{"date-parts":[[2006,6,16]],"date-time":"2006-06-16T19:33:11Z","timestamp":1150486391000},"page":"1012-1016","source":"Crossref","is-referenced-by-count":40,"title":["Patterns of lymphatic spread of carcinoma of the ampulla of Vater"],"prefix":"10.1093","volume":"84","author":[{"given":"Y","family":"Shirai","sequence":"first","affiliation":[{"name":"Department of Surgery, Niigata University School of Medicine , 1 Asahimachi-don, Niigata City 951,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T","family":"Ohtani","sequence":"additional","affiliation":[{"name":"Department of Surgery, Niigata University School of Medicine , 1 Asahimachi-don, Niigata City 951,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K","family":"Tsukada","sequence":"additional","affiliation":[{"name":"Department of Surgery, Niigata University School of Medicine , 1 Asahimachi-don, Niigata City 951,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K","family":"Hatakeyama","sequence":"additional","affiliation":[{"name":"Department of Surgery, Niigata University School of Medicine , 1 Asahimachi-don, Niigata City 951,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[1997,7,1]]},"reference":[{"key":"2024092919563655500_bib1","doi-asserted-by":"crossref","first-page":"880","DOI":"10.1002\/1097-0142(197803)41:3<880::AID-CNCR2820410315>3.0.CO;2-J","article-title":"Lymph node involvement in carcinoma of the head of the pancreas area","volume":"41","author":"Cubilla","year":"1978","journal-title":"Cancer"},{"key":"2024092919563655500_bib2","doi-asserted-by":"crossref","first-page":"2061","DOI":"10.1002\/1097-0142(19921015)70:8<2061::AID-CNCR2820700808>3.0.CO;2-V","article-title":"Lymphatic flow in carcinoma of the head of the pancreas","volume":"70","author":"Kayahara","year":"1992","journal-title":"Cancer"},{"key":"2024092919563655500_bib3","doi-asserted-by":"crossref","first-page":"1155","DOI":"10.1002\/1097-0142(19940215)73:4<1155::AID-CNCR2820730406>3.0.CO;2-H","article-title":"Clinical study of lymphatic flow to the paraaortic lymph nodes in carcinoma of the head of the pancreas","volume":"73","author":"Nagakawa","year":"1994","journal-title":"Cancer"},{"key":"2024092919563655500_bib4","first-page":"457","article-title":"A clinical study on lymphatic flow in carcinoma of the pancreatic head area-peripancreatic regional lymph node grouping","volume":"40","author":"Nagakawa","year":"1993","journal-title":"Hepatogastroenterology"},{"key":"2024092919563655500_bib5","first-page":"208","article-title":"The mode of lymphatic and local spread of pancreatic carcinomas less than 4.0 cm in size","volume":"78","author":"Ohta","year":"1993","journal-title":"Int Surg"},{"key":"2024092919563655500_bib6","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1159\/000172090","article-title":"Clinicopathologic study of carcinoma of the papilla of Vater with careful evaluation of lymph node metastases","volume":"9","author":"Mori","year":"1992","journal-title":"Dig Surg"},{"key":"2024092919563655500_bib7","doi-asserted-by":"crossref","first-page":"418","DOI":"10.1097\/00000658-198404000-00008","article-title":"Regional pancreatectomy for cancer of the pancreas, ampulla, and other related sites. 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