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© 2020 Society for used Microbiology and John Wiley Sons Ltd.BACKGROUND Lymph node metastasis is an important prognostic element for distal bile duct cancer. The amount of lymph node metastases ended up being followed for nodal classification. Nonetheless, various cutoff values have-been recommended, ranging from two to five. METHODS an overall total of 1,748 instances who underwent curative surgery with pancreatoduodenectomy for distal bile duct disease subscribed in the nationwide biliary