J.Jpn. Surg. Soc.. 88(3): 308-317, 1981

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Original article

AN ANATOMICAL AND PATHOLOGICAL STUDY OF AUTOPSY MATERIAL ON METASTASIS OF PANCREATIC CANCER TO PARA-AORTIC LYMPH NODES

The purpose of the present study was to clarify 1) the anatomy of the lymphatic system of the para-aortic region with special reference to lymphatic pathways from the pancreas, and 2) the incidence and extent of lymphatic metastases of pancreatic cancer to para-aortic lymph nodes.
1) Lymph nodes were found mostly on the bilateral and anterior sides of the aorta, and rarely on its posterior side. Lymphatic vessels from the pancreas (peripancreatic nodes) were closely related to the para-aortic lymph nodes on the bilateral and anterior surfaces of the aorta ranging from the root of theceliac artery and that of the inferior mesenteric artery.
2) Out of 10 autopsy cases of relatively small pancreatic cancer, 4 cases were found to have microscopic metastases in a few para-aortic lymph nodes. The localization of involved para-aortic nodes was compatible with that of anatomically related para-aortic lymph nodes.
Lymph node dissection of the para-aortic region, if carried out in a patient with a possibility of radical resection of the primary pancreatic cancer, should be an en bloc resection of lymph nodes and surrounding soft tissues in the area ranging between the root of the celiac artery and that of the inferior mesenteric artery.

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