Portal Lymphadenectomy: Technical Pearls and Pitfalls
摘要
Portal lymphadenectomy is essential for the surgical management and accurate staging of biliary tract cancers, including intrahepatic, hilar, distal cholangiocarcinoma, and gallbladder cancer. This procedure is frequently underperformed or inadequately executed due to the complexity of lymphadenectomy around the intricate anatomical variations involving the hepatic artery, portal vein, and bile duct. High-quality preoperative imaging significantly aids in identifying these variations. Evidence favors an open approach for higher lymph node yields, although minimally invasive techniques, particularly robotic surgery, show promising outcomes due to enhanced visualization and precision. This chapter highlights essential technical considerations, detailed procedural steps, and strategies to avoid complications such as vascular injuries and chyle leaks. Mastering these technical nuances is vital to improving surgical outcomes and prognostic accuracy in patients undergoing resection for biliary tract cancers.