Modified pancreaticoduodenectomy: A viable alternative to hepatopancreaticoduodenectomy for middle-third cholangiocarcinoma

The study compared the outcomes of patients with middle-third cholangiocarcinoma who underwent modified pancreaticoduodenectomy (MPD) or hepatopancreaticoduodenectomy (HPD). The MPD group exhibited advantages such as shorter operation time, less blood loss, and fewer complications compared to the HPD group. Overall survival rates did not significantly differ between the groups. The study identified positive surgical margins as the sole independent prognostic factor and noted that five-year survival rates improved for MPD patients with grossly tumor-free margins ≥15 mm, comparable to that of HPD patients. MPD may be recommended based on preoperative radiological imaging results.