SURGICAL-TREATMENT FOR PROXIMAL BILE-DUCT CARCINOMA

Background. The surgical management of proximal bile duct carcinoma is controversial. There is no consensus among surgeons as to the indicat ions for radical resection, This article described personal experience with the different surgical procedures for patients with proximal bil e duct carcinoma, Methods, The medical records of fifty-two consecutiv e patients undergoing surgical resection over a 20-year period were re trospectively analysed in terms of pathology, perioperative, mortality , clinical course, and overall survival. Results, The 1-, 3- and 5-yea r survivals for the entire group were 63.3 %, 24.5 %,and 21.0 %, respe ctively. The results for local resection of the extrahepatic bile duct in 35 cases were unsatisfactory. Radical resection that included the right extended hepatic lobe, caudate lobe, and extrahepatic bile duct was performed in 9 patients and demonstrated an excellent 5 year survi val rate of 44.4%, However, hospital mortality was 22.2%. There was no significant difference among the operative procedures for patients wi th advanced disease. Conclusion, Radical resection remains the procedu re of choice in proximal bile duct carcinoma, However, results with su rgical therapy alone remain unsatisfactory, Multimodality treatment th at also includes radiotherapy and/or chemotherapy is recommended.