Abstract
Patients with carcinoma of the papilla of Vater have a more favorable prognosis after curative resection than those with ductal carcinoma of the pancreatic head or distal bile duct. However, even after apparently curative resection, some of the patients with carcinoma of the papilla of Vater will experience the local recurrence as well as the distant metastasis, and nodal status is considered to be one of the most important prognostic factors. Therefore, lymph node dissection is an important component of curative surgery, especially in case of advanced carcinoma of the papilla of Vater which apparently invades the pancreatic parenchyma. In this article, I will focus on the clinical significance of the exact D2 lymph node dissection based on the clinical anatomy, including lymph nodes around the superior mesenteric artery and around the root of the small-bowel mesentery.
