{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T20:49:56Z","timestamp":1785617396305,"version":"3.56.0"},"reference-count":29,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2011,12,28]],"date-time":"2011-12-28T00:00:00Z","timestamp":1325030400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Hepato Biliary Pancreat"],"published-print":{"date-parts":[[2012,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Limited resection is reserved for patients with high operative risk or benign adenomas. We aimed to define indications for limited resection of early ampulla of Vater carcinoma with curative intent through detailed preoperative examinations and histopathological evaluations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed a retrospective cohort study of all consecutive Japanese patients who underwent resection for ampulla of Vater neoplasms at our hospital from 1986 to 2010.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 75 patients were identified. Moderately\/poorly differentiated histology, lympho\u2010vascular\/perineural invasion, and duodenal\/pancreatic invasion were significant risk factors for lymph node metastases. Macroscopically, non\u2010exposed protruded\u2010 or ulcerative\u2010type disease did not correlate directly with lymph node metastases; however, these tumor types were associated with other invasive features. In a subset of early carcinomas fulfilling the conditions of exposed protruded adenoma or papillary\/well\u2010differentiated adenocarcinoma determined by endoscopic biopsy, negative duodenal invasion determined by endoscopic ultrasonography, no tumor infiltration into the pancreatic duct determined by intraductal ultrasound, and diameter of the pancreatic duct \u2a7d3 mm determined by endoscopic retrograde cholangiopancreatography (<jats:italic>N<\/jats:italic> = 11), the incidence of lymph node metastasis and tumor infiltration into the pancreatic duct was 0%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Strictly selected patients with early ampulla of Vater carcinomas may benefit from limited resection if the resected specimen is evaluated to confirm all histopathological criteria.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00534-011-0492-4","type":"journal-article","created":{"date-parts":[[2011,12,27]],"date-time":"2011-12-27T11:26:30Z","timestamp":1324985190000},"page":"707-716","source":"Crossref","is-referenced-by-count":14,"title":["Proposed indications for limited resection of early ampulla of Vater carcinoma: clinico\u2010histopathological criteria to confirm cure"],"prefix":"10.1002","volume":"19","author":[{"given":"Koichi","family":"Aiura","sequence":"first","affiliation":[{"name":"Department of Surgery Kawasaki Municipal Hospital  Shinkawadori 12, Kawasaki\u2010ku Kawasaki Kanagawa 210\u20100013 Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taizo","family":"Hibi","sequence":"additional","affiliation":[{"name":"Department of Surgery Keio University School of Medicine  Tokyo 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