Distal bile duct cancer and papillary cancer occur in the lower portion of the bile duct as shown in the figure, and “pancreaticoduodenectomy” is required for curative resection. Pancreaticoduodenectomy is an operation to remove the head of the pancreas, duodenum, bile duct, gallbladder, and the gastric outlet, and is one of the major operations in abdominal surgery. Because food pathways (i.e., the stomach and duodenum), bile and pancreatic juice pathways are removed, this procedure requires complex reconstruction of all these routes using the jejunum. Since is it a laborious operation, the operation time tends to be long.
However, it is also known that cancers that occur on the downstream side of the biliary tract have a relatively good prognosis after resection, compared to cancers that occur on the upstream side of the biliary tract. Therefore, surgical resection is the first choice of treatment to expect to cure patients as long as there are no signs of distant metastases.