{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,24]],"date-time":"2025-10-24T07:27:40Z","timestamp":1761290860423},"reference-count":22,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2005,3,22]],"date-time":"2005-03-22T00:00:00Z","timestamp":1111449600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2005,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Jaundice is a common manifestation of ampullary carcinoma. The aim of this study was to evaluate the correlation between jaundice at initial presentation and the degree of tumor spread and to determine the prognostic significance of jaundice in patients with ampullary carcinoma. Fifty\u2010nine patients who had undergone curative resection for ampullary carcinoma were analyzed retrospectively. Jaundice was defined as a total bilirubin serum concentration of \u2265 3\u00a0mg\/dl. The median follow\u2010up time was 106\u00a0months. Jaundice was noted at the time of initial presentation in 43 (73%) patients. Jaundice at presentation correlated with lymph node metastasis (<jats:italic>p<\/jats:italic> &lt; 0.0001), lymphatic vessel invasion (<jats:italic>p<\/jats:italic> &lt; 0.0001), invasion into the pancreas (<jats:italic>p<\/jats:italic> = 0.0007), and vascular invasion (<jats:italic>p<\/jats:italic> = 0.0487). Pancreatic invasion was absent in patients without jaundice. Superior mesenteric nodal involvement was more frequent in patients with jaundice (15\/43) than in those without (0\/16) (<jats:italic>p<\/jats:italic> = 0.0062). The survival of patients with jaundice (median survival 48\u00a0months; cumulative 10\u2010year survival rate 39%) was worse than for patients without jaundice (median survival time not available; cumulative 10\u2010year survival rate 86%) (<jats:italic>p<\/jats:italic> = 0.0014). In conclusion, jaundice at presentation predicts advanced\u2010stage ampullary carcinoma and a poor prognosis. Pancreatic invasion and superior mesenteric nodal involvement were not observed in nonjaundiced patients.<\/jats:p>","DOI":"10.1007\/s00268-004-7709-5","type":"journal-article","created":{"date-parts":[[2005,3,15]],"date-time":"2005-03-15T19:28:56Z","timestamp":1110914936000},"page":"519-523","source":"Crossref","is-referenced-by-count":33,"title":["Jaundice at Presentation Heralds Advanced Disease and Poor Prognosis in Patients with Ampullary Carcinoma"],"prefix":"10.1002","volume":"29","author":[{"given":"Naoyuki","family":"Yokoyama","sequence":"first","affiliation":[{"name":"Division of Digestive and General Surgery Niigata University Graduate School of Medical and Dental Sciences Asahimachi\u2010dori 1\u2010757 951\u20108510 Niigata Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshio","family":"Shirai","sequence":"additional","affiliation":[{"name":"Division of Digestive and General Surgery Niigata University Graduate School of Medical and Dental Sciences Asahimachi\u2010dori 1\u2010757 951\u20108510 Niigata Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Toshifumi","family":"Wakai","sequence":"additional","affiliation":[{"name":"Division of Digestive and General Surgery Niigata University Graduate School of Medical and Dental Sciences Asahimachi\u2010dori 1\u2010757 951\u20108510 Niigata Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shigenori","family":"Nagakura","sequence":"additional","affiliation":[{"name":"Division of Digestive and General Surgery Niigata University Graduate School of Medical and Dental Sciences Asahimachi\u2010dori 1\u2010757 951\u20108510 Niigata Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kohei","family":"Akazawa","sequence":"additional","affiliation":[{"name":"Department of Medical Informatics Niigata University Medical and Dental Hospital Asahimachi\u2010dori 1\u2010754 951\u20108520 Niigata Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katsuyoshi","family":"Hatakeyama","sequence":"additional","affiliation":[{"name":"Division of Digestive and General Surgery Niigata University Graduate School of Medical and Dental Sciences Asahimachi\u2010dori 1\u2010757 951\u20108510 Niigata Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2005,3,22]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800741025"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.1991.01410270099016"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.134.5.526"},{"key":"e_1_2_6_5_2","first-page":"147","article-title":"Long\u2010term survival following radical and palliative treatment of patients with carcinoma of the pancreas and papilla of Vater: the prognostic factors influencing the long\u2010term results; a prospective multicentre study","volume":"19","author":"Bakkevold KE","year":"1993","journal-title":"Eur. 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