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World J Gastrointest Surg. Nov 27, 2026; 18(11): 125509
Published online Nov 27, 2026. doi: 10.4240/wjgs.125509
Published online Nov 27, 2026. doi: 10.4240/wjgs.125509
Beyond station 16: A pathway-aware framework for gallbladder cancer lymphadenectomy after neoadjuvant therapy
Andrea Cavallaro, Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania 95123, Italy
Paolo Di Mattia, Department of Medicine and Surgery, University of Enna “Kore”, Enna 94100, Italy
Co-first authors: Andrea Cavallaro and Paolo Di Mattia.
Author contributions: Cavallaro A and Di Mattia P jointly conceived the review, developed the pathway-oriented surgical concept, and contributed to the anatomical-surgical framework of the manuscript, both authors participated in literature interpretation, surgical analysis, manuscript drafting, and critical revision of the intellectual content, qualified as the co-first authors of the paper, both authors approved the final version of the manuscript.
AI contribution statement: ChatGPT Edu was used solely for English language polishing and proofreading during manuscript preparation and revision. No AI tool was used to generate research data, perform data analysis, interpret results, select references, formulate clinical conclusions, or create the scientific content of the manuscript. All AI-assisted language edits were critically reviewed and revised by the authors, who take full responsibility for the accuracy, originality and integrity of the manuscript.
Conflict-of-interest statement: The authors declare no conflict of interest.
Corresponding author: Andrea Cavallaro, Department of General Surgery and Medical Surgical Specialties, University of Catania, Via S. Sofia 78, Catania 95123, Italy.
Received: July 9, 2026
Revised: August 31, 2026
Accepted: September 21, 2026
Published online: November 27, 2026
Processing time: 126 Days and 17.2 Hours
Revised: August 31, 2026
Accepted: September 21, 2026
Published online: November 27, 2026
Processing time: 126 Days and 17.2 Hours
Core Tip
Core Tip: Station 16 is better understood as the convergence basin of three gallbladder lymphatic pathways rather than as an isolated boundary. This Opinion Review proposes that pathway-aware reporting may complement lymph-node count by documenting station distribution. The framework remains hypothesis-generating: Selective clearance of stations 13, 17, 14 and 16a2-16b1 should not be considered a standard surgical requirement, and may be discussed only in medically fit responders after neoadjuvant therapy, when systemic progression is absent, R0 resection is realistic and expert hepatobiliary surgery is available.