Hepatic lymph nodes

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Hepatic lymph nodes
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Lymphatics of stomach, etc.
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Lymphatics of stomach, etc. The stomach has been turned upward.
Details
System Lymphatic system
Drains to Celiac lymph nodes
Identifiers
Latin nodi lymphoidei hepatici
lymphoglandulae hepaticae
Anatomical terminology
Visceral nodes of the abdominal cavity Illu lymph chain08.jpg
Visceral nodes of the abdominal cavity

The hepatic lymph nodes consist of the following groups:

The lymph nodes of the hepatic chain receive afferents from the stomach, duodenum, liver, gall-bladder, and pancreas; their efferents join the celiac group of preaortic lymph nodes.

Cancer prognosis and treatment

Hepatic artery lymph nodes are commonly resected during a Whipple procedure. In a Whipple procedure, outcomes favored those who had no hepatic artery lymph node involvement. [1] [2] [3]

A particularly large hepatic artery lymph node, positioned on the anterior aspect of the common hepatic artery, is thought to play an important role in pancreatic cancer. When metastatic disease is identified in the hepatic artery lymph node during pancreatic cancer surgery, longterm outcomes are worse. [1] [4]

Related Research Articles

<span class="mw-page-title-main">Pancreas</span> Organ of the digestive system and endocrine system of vertebrates

The pancreas is an organ of the digestive system and endocrine system of vertebrates. In humans, it is located in the abdomen behind the stomach and functions as a gland. The pancreas is a mixed or heterocrine gland, i.e., it has both an endocrine and a digestive exocrine function. 99% of the pancreas is exocrine and 1% is endocrine. As an endocrine gland, it functions mostly to regulate blood sugar levels, secreting the hormones insulin, glucagon, somatostatin and pancreatic polypeptide. As a part of the digestive system, it functions as an exocrine gland secreting pancreatic juice into the duodenum through the pancreatic duct. This juice contains bicarbonate, which neutralizes acid entering the duodenum from the stomach; and digestive enzymes, which break down carbohydrates, proteins and fats in food entering the duodenum from the stomach.

<span class="mw-page-title-main">Duodenum</span> First section of the small intestine

The duodenum is the first section of the small intestine in most higher vertebrates, including mammals, reptiles, and birds. In mammals it may be the principal site for iron absorption. The duodenum precedes the jejunum and ileum and is the shortest part of the small intestine.

<span class="mw-page-title-main">Gallbladder</span> Organ in humans and other vertebrates

In vertebrates, the gallbladder, also known as the cholecyst, is a small hollow organ where bile is stored and concentrated before it is released into the small intestine. In humans, the pear-shaped gallbladder lies beneath the liver, although the structure and position of the gallbladder can vary significantly among animal species. It receives bile, produced by the liver, via the common hepatic duct, and stores it. The bile is then released via the common bile duct into the duodenum, where the bile helps in the digestion of fats.

<span class="mw-page-title-main">Bile duct</span> Type of organ

A bile duct is any of a number of long tube-like structures that carry bile, and is present in most vertebrates. The bile duct is separated into three main parts: the fundus (superior), the body (middle), and the neck (inferior).

<span class="mw-page-title-main">Pancreatic cancer</span> Type of endocrine gland cancer

Pancreatic cancer arises when cells in the pancreas, a glandular organ behind the stomach, begin to multiply out of control and form a mass. These cancerous cells have the ability to invade other parts of the body. A number of types of pancreatic cancer are known.

<span class="mw-page-title-main">Common bile duct</span> Gastrointestinal duct

The bile duct is a part of the biliary tract. It is formed by the union of the common hepatic duct and cystic duct. It ends by uniting with the pancreatic duct to form the hepatopancreatic ampulla. It possesses its own sphincter to enable regulation of bile flow.

Courvoisier's principle states that a painless palpably enlarged gallbladder accompanied with mild jaundice is unlikely to be caused by gallstones. Usually, the term is used to describe the physical examination finding of the right-upper quadrant of the abdomen. This sign implicates possible malignancy of the gallbladder or pancreas and the swelling is unlikely due to gallstones.

<span class="mw-page-title-main">Pancreaticoduodenectomy</span> Major surgical procedure involving the pancreas, duodenum, and other organs

A pancreaticoduodenectomy, also known as a Whipple procedure, is a major surgical operation most often performed to remove cancerous tumours from the head of the pancreas. It is also used for the treatment of pancreatic or duodenal trauma, or chronic pancreatitis. Due to the shared blood supply of organs in the proximal gastrointestinal system, surgical removal of the head of the pancreas also necessitates removal of the duodenum, proximal jejunum, gallbladder, and, occasionally, part of the stomach.

The Kocher manoeuvre is a surgical procedure to expose structures in the retroperitoneum behind the duodenum and pancreas. In vascular surgery, it is described as a method to expose the abdominal aorta. It usually has been in contrast to midline laparotomy and right retroperitoneal space dissection. These two procedures have been used for diverse cases, but have approximately equivalent outcomes.

<span class="mw-page-title-main">Duodenal cancer</span> Medical condition

Duodenal cancer is a cancer in the first section of the small intestine known as the duodenum. Cancer of the duodenum is relatively rare compared to stomach cancer and colorectal cancer. Its histology is usually adenocarcinoma.

<span class="mw-page-title-main">Gastrinoma</span> Medical condition

Gastrinomas are neuroendocrine tumors (NETs), usually located in the duodenum or pancreas, that secrete gastrin and cause a clinical syndrome known as Zollinger–Ellison syndrome (ZES). A large number of gastrinomas develop in the pancreas or duodenum, with near-equal frequency, and approximately 10% arise as primary neoplasms in lymph nodes of the pancreaticoduodenal region.

<span class="mw-page-title-main">Pelvic exenteration</span> Surgical removal of all pelvic organs

Pelvic exenteration is a radical surgical treatment that removes all organs from a person's pelvic cavity. It is used to treat certain advanced or recurrent cancers. The urinary bladder, urethra, rectum, and anus are removed. In women, the vagina, cervix, uterus, Fallopian tubes, ovaries and, in some cases, the vulva are removed. In men, the prostate is removed. The procedure leaves the person with a permanent colostomy and urinary diversion.

Hepatectomy is the surgical resection of the liver. While the term is often employed for the removal of the liver from a liver transplant donor, this article will focus on partial resections of hepatic tissue and hepatoportoenterostomy.

<span class="mw-page-title-main">Endoscopic ultrasound</span> Medical imaging procedure

Endoscopic ultrasound (EUS) or echo-endoscopy is a medical procedure in which endoscopy is combined with ultrasound to obtain images of the internal organs in the chest, abdomen and colon. It can be used to visualize the walls of these organs, or to look at adjacent structures. Combined with Doppler imaging, nearby blood vessels can also be evaluated.

<span class="mw-page-title-main">Neuroendocrine tumor</span> Medical condition

Neuroendocrine tumors (NETs) are neoplasms that arise from cells of the endocrine (hormonal) and nervous systems. They most commonly occur in the intestine, where they are often called carcinoid tumors, but they are also found in the pancreas, lung, and the rest of the body.

<span class="mw-page-title-main">Hemosuccus pancreaticus</span> Medical condition

Hemosuccus pancreaticus is a rare cause of hemorrhage in the gastrointestinal tract. It is caused by a bleeding source in the pancreas, pancreatic duct, or structures adjacent to the pancreas, such as the splenic artery, that bleed into the pancreatic duct, which is connected with the bowel at the duodenum, the first part of the small intestine. Patients with hemosuccus may develop symptoms of gastrointestinal hemorrhage, such as blood in the stools, maroon stools, or melena, which is a dark, tarry stool caused by digestion of red blood cells. They may also develop abdominal pain. It is associated with pancreatitis, pancreatic cancer and aneurysms of the splenic artery. Hemosuccus may be identified with endoscopy (esophagogastroduodenoscopy), where fresh blood may be seen from the pancreatic duct. Alternatively, angiography may be used to inject the celiac axis to determine the blood vessel that is bleeding. This may also be used to treat hemosuccus, as embolization of the end vessel may terminate the hemorrhage. However, a distal pancreatectomy—surgery to remove of the tail of the pancreas—may be required to stop the hemorrhage.

<span class="mw-page-title-main">Celiac lymph nodes</span>

The celiac lymph nodes are associated with the branches of the celiac artery. Other lymph nodes in the abdomen are associated with the superior and inferior mesenteric arteries. The celiac lymph nodes are grouped into three sets: the gastric, hepatic and splenic lymph nodes. They receive lymph from the stomach, duodenum, pancreas, spleen, liver, and gall bladder.

Hepatic arterial infusion (HAI) is a medical procedure that delivers chemotherapy directly to the liver. The procedure, mostly used in combination with systemic chemotherapy, plays a role in the treatment of liver metastases in patients with colorectal cancer (CRC). Although surgical resection remains the standard of care for these liver metastases, majority of patients have lesions that are unresectable.

<span class="mw-page-title-main">Periampullary cancer</span> Disease

Periampullary cancer is a cancer that forms near the ampulla of Vater, an enlargement of the ducts from the liver and pancreas where they join and enter the small intestine. It consists of:

  1. ampullary tumour from ampulla of Vater
  2. cancer of lower common bile duct
  3. duodenal cancer adjacent to ampulla
  4. carcinoma head of pancreas

Radiation lobectomy is a form of radiation therapy used in interventional radiology to treat liver cancer. It is performed in patients that would be surgical candidates for resection, but cannot undergo surgery due to insufficient remaining liver tissue. It consists of injecting small radioactive beads loaded with yttrium-90 into the hepatic artery feeding the hepatic lobe in which the tumor is located. This is done with the intent of inducing growth in the contralateral hepatic lobe, not dissimilarly from portal vein embolization (PVE).

References

PD-icon.svgThis article incorporates text in the public domain from page 706 of the 20th edition of Gray's Anatomy (1918)

  1. 1 2 van Rijssen, LB; Narwade, P; van Huijgevoort, NC; Tseng, DS; van Santvoort, HC; Molenaar, IQ; van Laarhoven, HW; van Eijck, CH; Busch, OR; Besselink, MG; Dutch Pancreatic Cancer, Group. (July 2016). "Prognostic value of lymph node metastases detected during surgical exploration for pancreatic or periampullary cancer: a systematic review and meta-analysis". HPB. 18 (7): 559–66. doi: 10.1016/j.hpb.2016.05.001 . PMC   4925793 . PMID   27346135.
  2. Saraee, Amir; Vahedian-Ardakani, Jalal; Saraee, Ehsan; Pakzad, Roshanak; Wadji, Massoud (2015). "Whipple procedure: a review of a 7-year clinical experience in a referral center for hepatobiliary and pancreas diseases". World Journal of Surgical Oncology. 13 (1): 98. doi: 10.1186/s12957-015-0523-8 . PMC   4363458 . PMID   25885408.
  3. LaFemina, J.; Chou, J. F.; Gönen, M.; Rocha, F. G.; Correa-Gallego, C.; Kingham, T. P.; Fong, Y.; D’Angelica, M. I.; Jarnagin, W. R.; DeMatteo, R. P.; Allen, P. J. (June 1, 2013). "Hepatic Arterial Nodal Metastases in Pancreatic Cancer: Is This the Node of Importance?". Journal of Gastrointestinal Surgery. 17 (6): 1092–1097. doi:10.1007/s11605-012-2071-7. PMID   23588624. S2CID   30984456.
  4. Cordera, Fernando; Arciero, Cletus A.; Li, Tianyu; Watson, James C.; Hoffman, John P. (August 2007). "Significance of common hepatic artery lymph node metastases during pancreaticoduodenectomy for pancreatic head adenocarcinoma". Annals of Surgical Oncology. 14 (8): 2330–2336. doi:10.1245/s10434-006-9339-7. ISSN   1068-9265. PMID   17492334. S2CID   739244.