title: Curative resection of carcinoma of the ampulla of Vater with lymph node metastases around the abdominal aorta after chemotherapy: A case report.
abstract: BACKGROUND
  For carcinoma of the ampulla of Vater, lymph node metastasis around the abdominal aorta is an inoperable factor equivalent to distant metastasis, such as hepatic metastasis or peritoneal carcinomatosis, making the cancer unresectable.
  
  
  METHODS
  A 53-year-old man was referred to our hospital and was diagnosed as having carcinoma of the ampulla of Vater with lymph node metastases around the abdominal aorta. Although only chemotherapy was initially scheduled, the chemotherapy was effective, and the metastases were dramatically reduced after 4 cycles of chemotherapy. Curative surgical resection was performed.
  
  
  CONCLUSIONS
  There were only eight case reports describing curative resections of initially unresectable biliary tract carcinomas excluding intrahepatic cholangiocellular carcinoma after chemotherapy.
  
  
  CONCLUSIONS
  Curative surgical resection after chemotherapy may be a feasible treatment plan in patients with unresectable biliary tract cancer.
authors.affiliation: Department of Surgery, Kameda Medical Center, Japan. Electronic address: fujii.wataru@kameda.jp.
authors.forename: Wataru
authors.initials: W
authors.lastname: Fujii
authors.affiliation: Department of Surgery, Kameda Medical Center, Japan.
authors.forename: Ken
authors.initials: K
authors.lastname: Hayashi
authors.affiliation: Department of Surgery, Kameda Medical Center, Japan.
authors.forename: Shigetoshi
authors.initials: S
authors.lastname: Yamada
authors.affiliation: Department of Surgery, Kameda Medical Center, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kusanagi
keywords: Ampulla vater; Case report; Chemotherapy; Curative resection