Extrahepatic bile duct carcinoma: A western experience with 118 consecutive patients

Background/Aims: This study was designed to evaluate the effectiveness of a diagnostic and therapeutic approach adopted in 118 consecutive patients af fected by primary malignancy of the extrahepatic bile duct. Methodology: After diagnostic procedures were performed (ultrasound examina tion, endoscopic retrograde cholangiopancreatography and computed tomograph y scan) 25 patients underwent surgical resection, For the remaining 93 pati ents considered unresectable for cure, stenting by endoscopic means was alm ost always the only palliative treatment performed. Results: The morbidity and mortality rates were 28% and 8% far patients tre ated with surgical resection and the curative and overall 3-year survival r ate was 30% and 22% respectively. The procedure related morbidity and morta lity rates were 13% and 4% for patients endoscopically treated and the medi an survival rate was 7.3 months. The quality of life evaluated in 68 patien ts out of 93 was good in 57% of cases, fair in 19% and poor in the remainin g 22%. Conclusions: The results of the present study demonstrate the safety and ef ficacy of endoscopic stenting in the palliative treatment of extrahepatic b ile duct cancer while potential cure can only be achieved by radical surgic al resection.