{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T10:07:16Z","timestamp":1779790036752,"version":"3.53.1"},"reference-count":27,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,1,26]],"date-time":"2026-01-26T00:00:00Z","timestamp":1769385600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,26]],"date-time":"2026-01-26T00:00:00Z","timestamp":1769385600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Hepato Biliary Pancreat"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background\/Purpose<\/jats:title>\n                    <jats:p>Preoperative diagnosis of para\u2010aortic lymph node (PALN) metastasis, particularly at station 16b1\u2014a contraindication to pancreatic ductal adenocarcinoma (PDAC) resection\u2014remains challenging. We investigated whether the distance from the root of the splenic artery (SPA) to the tumor (DST) is an objective predictor of PALN metastasis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analyzed 130 patients who underwent distal pancreatectomy with PALN sampling for PDAC from 2012 to 2022. DST was measured using preoperative contrast\u2010enhanced computed tomography. Receiver operating characteristic (ROC) analysis was performed, and clinicopathological factors were analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      PALN metastasis occurred in 7\/130 (5.4%) patients. DST was significantly shorter in the PALN\u2010positive group (median: 12.0 vs. 18.0\u2009mm,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0001). ROC analysis indicated that the optimal cutoff value was 20.0\u2009mm. In univariate and multivariate analyses, DST \u2264\u200920.0\u2009mm was the only factor significantly associated with PALN metastasis (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0042 and\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0093, respectively). All PALN\u2010positive cases had DST \u2264\u200920.0\u2009mm.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>DST is a clinically useful metric for predicting PALN metastasis in left\u2010sided PDAC. In patients with DST\u2009&gt;\u200920\u2009mm, the likelihood of PALN involvement appeared extremely low, suggesting that intraoperative lymph node sampling may be omitted in selected patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jhbp.70074","type":"journal-article","created":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T06:22:42Z","timestamp":1769494962000},"page":"389-396","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Distance From the Root of the Splenic Artery to the Tumor as a Predictor of Para\u2010Aortic Lymph Node Metastasis in Left\u2010Sided Pancreatic Cancer"],"prefix":"10.1002","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3379-3890","authenticated-orcid":false,"given":"Kotaro","family":"Kimura","sequence":"first","affiliation":[{"name":"Department of Surgery Teine Keijinkai Hospital  Sapporo Hokkaido Japan"},{"name":"Department of Gastroenterological Surgery II, Faculty of Medicine Hokkaido University  Sapporo Hokkaido Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shoki","family":"Sato","sequence":"additional","affiliation":[{"name":"Department of Surgery Teine Keijinkai Hospital  Sapporo Hokkaido Japan"},{"name":"Department of Gastroenterological Surgery II, Faculty of Medicine Hokkaido University  Sapporo Hokkaido Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-9920-6296","authenticated-orcid":false,"given":"Zen","family":"Naito","sequence":"additional","affiliation":[{"name":"Department of Surgery Teine Keijinkai Hospital  Sapporo Hokkaido Japan"},{"name":"Department of Gastroenterological Surgery II, Faculty of Medicine Hokkaido University  Sapporo Hokkaido Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2447-7770","authenticated-orcid":false,"given":"Hiroyuki","family":"Yamamoto","sequence":"additional","affiliation":[{"name":"Department of Surgery Teine Keijinkai Hospital  Sapporo Hokkaido Japan"},{"name":"Department of Gastroenterological Surgery II, Faculty of Medicine Hokkaido University  Sapporo Hokkaido Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomohiro","family":"Suzuki","sequence":"additional","affiliation":[{"name":"Department of Surgery Teine Keijinkai Hospital  Sapporo Hokkaido Japan"},{"name":"Department of Gastroenterological Surgery II, Faculty of Medicine Hokkaido University  Sapporo Hokkaido Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noriaki","family":"Kyogoku","sequence":"additional","affiliation":[{"name":"Department of Surgery Teine Keijinkai Hospital  Sapporo Hokkaido Japan"},{"name":"Department of 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Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2612-9913","authenticated-orcid":false,"given":"Satoshi","family":"Hirano","sequence":"additional","affiliation":[{"name":"Department of Gastroenterological Surgery II, Faculty of Medicine Hokkaido University  Sapporo Hokkaido 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