[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-366973-105":3,"detail-sidebar-cat-0-en-105":85,"doc-detail-366973-en":135},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":78,"head_meta":80,"extra_data":82,"updated_unix":84},105,"en","pancreaticoduodenectomy-for-second-periampullary-cancer-following-curative-resection-of-extrahepatic-bile-duct-cancer","Pancreaticoduodenectomy for Second Periampullary Cancer Following Curative Resection of Extrahepatic Bile Duct Cancer","","This retrospective study evaluated the feasibility and outcomes of pancreaticoduodenectomy (PD) as a second operation for metachronous periampullary carcinoma after curative resection of primary extrahepatic bile duct cancer. Seven patients underwent secondary PD between 2007 and 2024, with TNM staging using the 8th edition American Joint Committee on Cancer system. Mean interval between first and second cancers was 47 months. No perioperative deaths occurred, but postoperative complications occurred in 3 patients, including chyle leakage and a grade IIIb pancreatic fistula requiring reoperation.",{"@graph":14,"@context":77},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/pancreaticoduodenectomy-for-second-periampullary-cancer-following-curative-resection-of-extrahepatic-bile-duct-cancer/366973/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/pancreaticoduodenectomy-for-second-periampullary-cancer-following-curative-resection-of-extrahepatic-bile-duct-cancer/366973.png","ImageObject",300,407,{"name":42,"@type":43},"pixelkiddo","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-30","2026-09-23",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",11,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69,73],{"name":60,"@type":61,"acceptedAnswer":62},"What was the purpose of this study?","Question",{"text":63,"@type":64},"To evaluate the feasibility and clinical outcomes of surgical treatment for second primary periampullary carcinoma after curative resection of primary extrahepatic bile duct cancer.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"How many patients received a second pancreaticoduodenectomy, and what was the interval between cancers?",{"text":68,"@type":64},"Seven patients underwent secondary PD, and the mean interval between the first and second cancers was 47 months (range 13–121 months).",{"name":70,"@type":61,"acceptedAnswer":71},"What perioperative outcomes and complications were reported?",{"text":72,"@type":64},"No perioperative deaths occurred. Postoperative complications developed in 3 patients (42.9%), including chyle leakage (managed conservatively) and one grade IIIb postoperative pancreatic fistula requiring reoperation.",{"name":74,"@type":61,"acceptedAnswer":75},"What did follow-up show about recurrence and survival?",{"text":76,"@type":64},"During follow-up, four patients died of recurrence at 5, 12, 19, and 24 months. One patient underwent surgery for pulmonary metastasis after PD and remained alive without recurrence, while two patients were disease-free at 38 and 92 months.","https://schema.org",{"og:url":32,"og:type":79,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":81,"canonical":32},"index,follow",{"doc_id":83,"site_id":7},366973,1790195283,{"code":4,"msg":86,"data":87},"success",[88,92,96,100,105,110,114,119,124,127,131],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":97,"show_sort_weight":98,"slug":99},"Exam",70,"exam",{"id":101,"doc_module":4,"doc_module_name":25,"category_name":102,"show_sort_weight":103,"slug":104},5,"Comic",60,"comic",{"id":106,"doc_module":4,"doc_module_name":25,"category_name":107,"show_sort_weight":108,"slug":109},6,"Technology",50,"technology",{"id":111,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":112,"slug":113},7,40,"healthcare",{"id":115,"doc_module":4,"doc_module_name":25,"category_name":116,"show_sort_weight":117,"slug":118},8,"Research & Report",30,"research-report",{"id":120,"doc_module":4,"doc_module_name":25,"category_name":121,"show_sort_weight":122,"slug":123},9,"Religion & Spirituality",20,"religion-spirituality",{"id":122,"doc_module":4,"doc_module_name":25,"category_name":125,"show_sort_weight":122,"slug":126},"World Cup","world-cup",{"id":128,"doc_module":4,"doc_module_name":25,"category_name":129,"show_sort_weight":128,"slug":130},10,"Lifestyle","lifestyle",{"id":132,"doc_module":4,"doc_module_name":25,"category_name":133,"show_sort_weight":101,"slug":134},19,"General","general",{"code":4,"msg":86,"data":136},{"doc_id":83,"user_id":137,"nickname":42,"user_avatar":138,"doc_module":4,"category_id":111,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":139,"file_id":140,"file_url":141,"file_type":142,"file_size":143,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":106,"language":144,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":145,"faqs":146,"seo_title":147,"seo_description":12,"update_tm":148,"read_time":149},962090883892,"https://ap-avatar.wpscdn.com/avatar/e00115db34f3e0f11b?x-image-process=image/resize,m_fixed,w_180,h_180&k=1790152879550218658","pISSN: 2508-5778 ㆍeISSN: 2508-5859  \nAnn Hepatobiliary Pancreat Surg 2026;30:52-57 [https://doi.org/10.14701/ahbps.25-164](https://doi.org/10.14701/ahbps.25-164)  \nAHBPS  \nAnnals of Hepato-Biliary-Pancreatic Surgery  \nOriginal Article  \nPancreaticoduodenectomy for second periampullary cancer following curative resection of extrahepatic bile  \nduct cancer  \nMyeong Hun Oh1, Hyung Il Seo1, 2, Young Mok Park1, 2, Byeong Gwan Noh1, 2, Su Bin Song1  \n1Department of Surgery, Biomedical Research Institute, Pusan National University Hospital, Busan, Korea, 2Department of Surgery, Pusan National University School of Medicine, Yangsan, Korea  \nBackgrounds/Aims: This study evaluated the feasibility and outcomes of surgical treatment for metachronous periampullary carcinoma following curative resection of primary extrahepatic bile duct cancer.  \nMethods: A retrospective review was conducted of seven patients who underwent pancreaticoduodenectomy (PD) for metachronous periampullary cancer after prior curative surgery for extrahepatic bile duct cancer.  \nResults: The mean age at the second surgery was 66.7 years (range, 43–81 years). Initial malignancies included three hilar cholangiocarcinomas, one middle bile duct cancer, and three gallbladder cancers. Subsequent primary tumors consisted of three distal bile duct cancers, three pancreatic head cancers, and one duodenal cancer. The mean interval between the first and second cancers was 47 months (range, 13–121 months). No perioperative deaths occurred. Postoperative complications developed in three patients (42.9%): chyle leakage (Clavien–Dindo grade II) in two (28.6%) and a grade C postoperative pancreatic fistula requiring reoperation (grade IIIb) in one (14.3%). Both chyle leaks were managed conservatively. During follow-up, four patients died of recurrence at 5, 12, 19, and 24 months postoperatively. One patient underwent video-assisted thoracoscopic surgery for pulmonary metastasis 2 months after PD and remains alive 22 months later without recurrence. Two patients are disease-free at 38 and 92 months of follow-up.  \nConclusions: PD for second primary periampullary cancer after resection of extrahepatic bile duct cancer appears feasible and potentially effective. Although no perioperative mortality occurred, major complications were observed. Larger studies are needed to confirm these preliminary findings.  \nKey Words: Neoplasms, second primary; Pancreaticoduodenectomy; General surgery; Bile duct neoplasms  \nINTRODUCTION  \nWhile the benefits of pancreaticoduodenectomy (PD) for primary periampullary malignancies are well established, there is limited information on its role in second periampullary lesions.  \nReceived: August 27, 2025, Revised: October 17, 2025,  \nAccepted: October 27, 2025, Published online: November 17, 2025  \nCorresponding author: Hyung Il Seo, MD, PhD  \nDepartment of Surgery, Pusan National University School of Medicine, 49 Busandaehak-ro, Yangsan 50612, Korea  \nTel: +82-51-240-7238, Fax: +82-51-247-1365, E-mail: [seohi71@pusan.ac.kr](seohi71@pusan.ac.kr)  \nORCID: [https://orcid.org/0000-0002-4132-7662](https://orcid.org/0000-0002-4132-7662)  \nCopyright Ⓒ The Korean Association of Hepato-Biliary-Pancreatic Surgery  \nThis is an Open Access article distributed under the terms of the Creative Commons Attri  \nbution Non-Commercial License ([http://creativecommons.org/licenses/by-nc/4.0](http://creativecommons.org/licenses/by-nc/4.0)) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.  \nComplete surgical resection is considered a potentially curative treatment for extrahepatic cholangiocarcinoma (EHCC). However, even with successful complete (R0) resection, the prognosis often remains poor due to a high rate of locoregional recurrence and systemic metastasis.  \nDuring postoperative surveillance following R0 resection, it is not uncommon to encounter cases of second primary malignancies","cbCaitmueaTaO76F","https://ap.wps.com/l/cbCaitmueaTaO76F","pdf",301402,"English","# Introduction\n# Methods\n# Results\n# Conclusions","[{\"question\":\"What was the purpose of this study?\",\"answer\":\"To evaluate the feasibility and clinical outcomes of surgical treatment for second primary periampullary carcinoma after curative resection of primary extrahepatic bile duct cancer.\"},{\"question\":\"How many patients received a second pancreaticoduodenectomy, and what was the interval between cancers?\",\"answer\":\"Seven patients underwent secondary PD, and the mean interval between the first and second cancers was 47 months (range 13–121 months).\"},{\"question\":\"What perioperative outcomes and complications were reported?\",\"answer\":\"No perioperative deaths occurred. Postoperative complications developed in 3 patients (42.9%), including chyle leakage (managed conservatively) and one grade IIIb postoperative pancreatic fistula requiring reoperation.\"},{\"question\":\"What did follow-up show about recurrence and survival?\",\"answer\":\"During follow-up, four patients died of recurrence at 5, 12, 19, and 24 months. One patient underwent surgery for pulmonary metastasis after PD and remained alive without recurrence, while two patients were disease-free at 38 and 92 months.\"}]","Pancreaticoduodenectomy for Second Periampullary Cancer Following Curative Resection of Extrahepatic Bile Duct Cancer | PDF",1790168517,15]