Role of Nodal Involvement and the Periductal Soft-Tissue Margin in Middle and Distal Bile Duct Cancer

Abstract

Absence of tumor at the surgical margin and nodal involvement are important independent prognostic factors in Bm and Bi disease. Skeletonization of the hepatoduodenal ligament, including portal vein resection, is necessary for patients with Bm disease, and a wide nodal dissection is essential in all patients.