J.Jpn. Surg. Soc.. 78(1): 1-12, 1977

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Original article

CARCINOMA OF THE PROXIMAL BILE DUCTS

The case records of 31 patients of carcinoma of the proximal bile ducts were reviewed and operative procedures, results, causes of deaths and autopsy findings were analysed and correlated. Ten poor-risk patients were treated by external drainage and died of jaundice or liver abscesses within 6 months. However, one patient survived 13 months by effective b lateral drainage. Twelve patients underwent intubation through the tumor into the hepatic ducts with or without postoperative irradiation. Four patients with irradiation survived 42, 15, 15 and 10 months, while 8 patients without irradiation died within 6 months. Autopsy findings of 2 patients who survived 15 months revealed metastases at the various organs. Four patients underwent resection. A patient who underwent resection of the common hepatic duct and hepaticoduodenostomy died of ascending cholangitis at 9 months postoperatively, while a patient treated by resection of the common hepatic duct with hepaticojejunostomy is living well after 13 months. Two patients underwent left hepatic lobectomy and resection of the right hepatic duct followed by hepatojejunostomy. One patient is living without janndice at 18 months postoperatively but the other patient died of ascending cholangitis at 10 months postoperatively. Difficult problems encountered with the radical operation are presented and discussed .

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