THE PATTERN OF LYMPHATIC SPREAD IN CARCINOMA OF THE DISTAL BILE-DUCT

From 1995 to 1996, 20 patients with carcinoma of the distal bile duct (Bi) and 16 with carcinoma of the pancreatic head (Ph) underwent pancr eaticoduodenectomy or total pancreatectomy with systematic extended ly mphadenectomy. Histopathological specimens were examined with special reference to nodal metastases, Pancreatic parenchymal invasion was pre sent in 10 of 20 patients with Pi. The frequency of nodal involvement in Bi with pancreatic invasion and Ph was significantly greater than i n Pi without pancreatic invasion (p < 0.05 and p < 0.01, respectively) . Metastasis to nodes around the superior mesenteric artery or abdomin al aorta in Bi with pancreatic invasion occurred more frequently than in Bi without pancreatic invasion (p < 0.05), though was not different from the frequency observed in Ph. The pattern of lymphatic spread in distal bile duct carcinoma with pancreatic invasion was practically e qual to the mode in carcinoma of the pancreatic head.