{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T13:08:52Z","timestamp":1787317732896,"version":"build-2736575974"},"reference-count":25,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2022,5,16]],"date-time":"2022-05-16T00:00:00Z","timestamp":1652659200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Surgical Oncology"],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>As minimally invasive surgery (MIS) approaches to biliary tract cancers become more commonplace, understanding the adequacy of their oncologic performance is key.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The National Cancer Database 2010\u20132016 was queried for patients who underwent hepatectomy for intrahepatic cholangiocarcinoma (IHC) and T1b or more advanced gallbladder cancer (GBC). Patients were grouped by approach: open (OA), laparoscopic (LA), and robotic (RA). Margin status, rate of lymph node (LN) dissection, and yield of LN dissection were evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>This cohort of 8612 patients, including 4034 patients with IHC (OA: 3281, LA: 675, RA: 78) and 4578 patients with GBC (OA: 1893, LA: 2588, RA: 97), MIS was used 40% of the time. R0 resection was achieved in 82% OA, 84% LA, and 91% RA, <jats:italic>p<\/jats:italic>\u2009=\u20090.004. Rate of LN dissection was 53% (OA: 60%, LA: 42%, RA: 51%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Among patients who underwent lymphadenectomy, 6\u2009+\u2009LN were retrieved less commonly with a LA (OA: 27%, LA: 20%, and RA: 30%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). High\u2010volume MIS hepatectomy centers were more likely to perform a lymphadenectomy (odds ratio [OR]: 1.41) and a sampling of 6\u2009+\u2009LN (OR: 1.18).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Regardless of approach, lymphadenectomy is underperformed nationwide for biliary tract tumors, particularly with LA. As the use of MIS grows for the treatment of biliary tract cancers, scrutiny of oncologic outcomes is required.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jso.26924","type":"journal-article","created":{"date-parts":[[2022,5,17]],"date-time":"2022-05-17T06:23:10Z","timestamp":1652768590000},"page":"658-666","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Lymphadenectomy and margin\u2010negative resection for biliary tract cancer surgery in the United States\u2014Differential technical performance by approach"],"prefix":"10.1002","volume":"126","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1832-5298","authenticated-orcid":false,"given":"Bradford J.","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Surgical Oncology The University of Texas MD Anderson Cancer Center Houston Texas 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