<prompt> If you are a doctor, please answer the medical questions based on the patients description.whiples operation on 1311findings: The distal stomach, bileduct, head of pancreas and proximal jejunum were removed. No obvious metastatsis in lymph node or liver were notedHistopathology: Periampullary Adenocarcinoma, Moderately differentiatedwhat treatement now  <response>: Thanks for your question on Chat Doctor. You are having adenocarcinoma. You are not having lymphatic spread as lymph nodes are negative for malignancy. The best treatment is surgical removal Whipple s operation and post-operative chemotherapy. Since you already had Whipple s operation, better to undergo post-operative chemotherapy. The main reason for this is to prevent local recurrence and distal metastasis. During surgery, handling of mass can cause local site spillage of tumor cells. So these can cause local recurrence. So to prevent this, chemotherapy is needed. So consult oncologist and discuss all these. 