Evidence map›Paper›PMID 41661327›Full record

ArticleSurgery today2026

Oncologic impact of additional pancreaticoduodenectomy for distal margin-positive perihilar cholangiocarcinoma: a multi-decade single-center analysis.

Koya Yasukawa, Akira Shimizu, Koji Kubota, Tsuyoshi Notake, Kiyotaka Hosoda, Hiroki Sakai, Hikaru Hayashi, Yuji Soejima

Abstract read
PubMed Publisher
In one paragraph

Article in Surgery today, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Koya YasukawaDivision of Gastroenterological, Hepato- Biliary-Pancreatic, Transplantation and Pediatric Surgery, Department of Surgery, Shinshu University School of Medicine, Asahi 3-1-1, Matsumoto, 390-8621, Japan.
Akira ShimizuDivision of Gastroenterological, Hepato- Biliary-Pancreatic, Transplantation and Pediatric Surgery, Department of Surgery, Shinshu University School of Medicine, Asahi 3-1-1, Matsumoto, 390-8621, Japan. ashimizu@shinshu-u.ac.jp.ORCID http://orcid.org/0000-0002-5015-1697
Koji KubotaDivision of Gastroenterological, Hepato- Biliary-Pancreatic, Transplantation and Pediatric Surgery, Department of Surgery, Shinshu University School of Medicine, Asahi 3-1-1, Matsumoto, 390-8621, Japan.
Tsuyoshi NotakeDivision of Gastroenterological, Hepato- Biliary-Pancreatic, Transplantation and Pediatric Surgery, Department of Surgery, Shinshu University School of Medicine, Asahi 3-1-1, Matsumoto, 390-8621, Japan.
Kiyotaka HosodaDivision of Gastroenterological, Hepato- Biliary-Pancreatic, Transplantation and Pediatric Surgery, Department of Surgery, Shinshu University School of Medicine, Asahi 3-1-1, Matsumoto, 390-8621, Japan.
Hiroki SakaiDivision of Gastroenterological, Hepato- Biliary-Pancreatic, Transplantation and Pediatric Surgery, Department of Surgery, Shinshu University School of Medicine, Asahi 3-1-1, Matsumoto, 390-8621, Japan.
Hikaru HayashiDivision of Gastroenterological, Hepato- Biliary-Pancreatic, Transplantation and Pediatric Surgery, Department of Surgery, Shinshu University School of Medicine, Asahi 3-1-1, Matsumoto, 390-8621, Japan.
Yuji SoejimaDivision of Gastroenterological, Hepato- Biliary-Pancreatic, Transplantation and Pediatric Surgery, Department of Surgery, Shinshu University School of Medicine, Asahi 3-1-1, Matsumoto, 390-8621, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposePerihilar cholangiocarcinoma (PHCC) often presents challenges with intraoperatively detected distal bile duct margin (DM) positivity. We evaluated the safety and oncological impact of performing an additional pancreatoduodenectomy (ad-PD) for converting R1 to R0 resection.

methodsWe retrospectively reviewed 272 patients (1990-2024) who underwent major hepatectomies for PHCC. Patients with positive DM were divided into an ad-PD group (n = 8) and a hepatectomy alone group (DMpos-HA, n = 10).

resultsA manalysis identified lymph node metastasis, non-R0 resection, vascular resection, and CA19-9 > 90 U/mL as independent predictors of a poor overall survival (OS) in the entire cohort (n = 272). Regarding the DM-positive subgroup, the ad-PD group achieved a 100% R0 rate, whereas the DMpos-HA group had a 0% rate (p < 0.001). The 5-year OS rate tended to be higher in the ad-PD group (50.0% vs. 20.0%, p = 0.396), although the difference was not statistically significant. Major complications (Clavien-Dindo ≥IIIa) occurred in 38% of the ad-PD group and 20% of the DMpos-HA group (p = 0.613). Importantly, the in-hospital mortality rate was 0% in both groups.

conclusionIn carefully selected patients, concomitant ad-PD is a feasible option that achieves a high R0 rate and suggests a trend toward an improved long-term survival without increasing mortality.

Indexed as

Bile Duct NeoplasmsKlatskin TumorMargins of ExcisionPancreaticoduodenectomyAgedFemaleHepatectomyHumansLymphatic MetastasisMaleMiddle AgedRetrospective StudiesSurvival RateTime FactorsTreatment OutcomeCurative surgeryDistal bile duct marginHepatopancreaticoduodenectomyPancreaticoduodenectomyPerihilar cholangiocarcinoma

Identifiers

PMID41661327

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.