Cystic duct margin
The cut end of the short duct that joined the gallbladder to the main bile duct, examined by the pathologist after a gallbladder is removed. If cancer cells reach this edge, part of the main bile duct usually has to be removed at a second operation; if it is clear, the bile duct can be left alone.
Overview
The cystic duct margin is the resection margin closest to the extrahepatic bile duct in every cholecystectomy specimen. The AHPBA consensus asks pathologists in high-incidence areas to examine it in every routine specimen alongside at least three sections of wall, and, at re-resection for gallbladder cancer, to resect the bile duct only when needed to achieve a negative (R0) margin, in practice when the cystic duct margin is positive (Aloia 2015; Soreide 2019). Frozen section of the bile duct margin during surgery is used to decide the extent of resection and generally agrees with the final result (Yamaguchi 2005). A positive margin, or dysplasia running into the duct, is also how a cystic duct carcinoma may first be suspected (Kim 2025). Margin status is listed among the pathological findings on the gallbladder cancer page because it changes the operation.
- Pancreatic head (most PDAC)
- Body and tail
- Ampulla
- Islets (pancreatic NET)
- Intrahepatic ducts
- Perihilar (Klatskin)
- Distal bile duct
- Gallbladder
- Nodes: peripancreatic
- Nodes: hepatic hilar
- Nodes: coeliac and superior mesenteric
Most pancreatic cancers arise in the head next to the bile duct, which is why jaundice is the presenting sign; bile duct cancers are named by where along the tree they sit.
- Pancreatic head (most PDAC)
- Body and tail
- Ampulla
- Islets (pancreatic NET)Neuroendocrine carcinoma of the gallbladder (small cell and large cell; under 5 percent)
- Intrahepatic ducts
- Perihilar (Klatskin)
- Distal bile duct
- GallbladderGallbladder adenocarcinoma (about 90 percent; biliary, intestinal, mucinous and other patterns) · Papillary carcinoma of the gallbladder, and its precursor the intracholecystic papillary neoplasm · Mucinous carcinoma of the gallbladder (about 2.5 percent) · Adenosquamous and squamous carcinoma of the gallbladder (about 5 percent) · Neuroendocrine carcinoma of the gallbladder (small cell and large cell; under 5 percent) · Incidental gallbladder cancer found in the cholecystectomy specimen · Carcinoma in situ and dysplasia of the gallbladder (biliary intraepithelial neoplasia; stage 0) · Cystic duct carcinoma (staged with gallbladder cancer)
- peripancreatic
- hepatic hilar
- coeliac and superior mesenteric
Same organ: Pancreatic ductal adenocarcinoma, Biliary tract cancer (cholangiocarcinoma), Intrahepatic cholangiocarcinoma, Extrahepatic cholangiocarcinoma (perihilar and distal), Biliary tract cancer (all types), Neuroendocrine tumours, Pancreatic neuroendocrine tumours, Grade 3 well-differentiated neuroendocrine tumour, Extrapulmonary neuroendocrine carcinoma, Gallbladder adenocarcinoma, Papillary carcinoma of the gallbladder, Mucinous carcinoma of the gallbladder, Adenosquamous and squamous carcinoma of the gallbladder, Neuroendocrine carcinoma of the gallbladder, Incidental gallbladder cancer (found after cholecystectomy), Carcinoma in situ and dysplasia of the gallbladder, Cystic duct carcinoma, Ampullary cancer (ampulla of Vater), Resectable pancreatic ductal adenocarcinoma, Borderline resectable pancreatic ductal adenocarcinoma, Locally advanced unresectable pancreatic ductal adenocarcinoma, Metastatic pancreatic ductal adenocarcinoma, KRAS G12C-mutant pancreatic ductal adenocarcinoma, KRAS wild-type pancreatic ductal adenocarcinoma, BRCA or PALB2-mutant pancreatic ductal adenocarcinoma, Mismatch repair deficient (MSI-high) pancreatic ductal adenocarcinoma, Pancreatic acinar cell carcinoma, Intraductal papillary mucinous neoplasm and other pancreatic cystic precursors, Pancreatoblastoma
Showing the organ this term concerns: Gallbladder cancer.
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