Mucin ball-producing extrahepatic bile duct carcinoma

The characteristic features of surgically curable mucin-producing extrahepa tic bile duct carcinoma (MPEBC) have not previously been elucidated. Three (6.5% of 46 patients who underwent surgery in our department for bile duct carcinoma between 1986 and 1997 had MPEBC. Clinicopathological features, di agnostic procedures and operative methods for patients with MPEBC were inve stigated. Tumors in the bile duct were identified by cholangioscopy combine d with cholangiography after removal of mucin balls. Tumors were located cl ose to the hepatic confluence in these patients. Two patients underwent hep atic lobectomy together with caudate lobectomy while the other underwent re section of the hepatic confluence. Absence of residual tumors was confirmed histologically in these patients. All three patients remain alive without evidence of recurrence, 22-54 months after surgery. MPEBC is a curable dise ase. Accurate localization in the biliary tree is essential and can only be obtained after, i) removal of mucin balls, and ii) extensive diagnostic wo rk-up including cholangiography, cholangioscopy and intraoperative patholog ical examination.