Abstract
A series of 50 resected cases of hilar bile duct carcinoma were subjected to a study of elucidating the appropriate lymph nodes dissection according to the local extent of the tumor by exploring the status of lymph node metastasis. Five-year survival rate of patients without lymph node metastasis and that with nl metastasis were 15.3%, and 14.3%, respectively. Each one patient surviving more than 5 years was recorded in both patient groups. No patient with n2 or n3 metastasis survived beyond 17 months. The most frequent site of lymph node metastasis was No.8 (a, p), followed by 12b and 12p. N3 lymph node metastases were rare. Jumping metastases were found in No. 5 and 6 (suprapylolic or infrapylolic lymph node). As for appropriate lymph node dissection according to the extent of the tumor, D2 is recommended for the standard dissection, and No.5 and 6 lymph nodes should be resected besides. When lymph node metastasis is found in N2 or N3, we should not perform extended resections.
