J.Jpn. Surg. Soc.. 79(8): 783-787, 1978
Report on the annual meeting
SURGICAL REMOVAL OF THE CARCINOMA AT THE JUNCTION OF THE MAIN HEPATIC DUCT WITHOUT HEPATECTOMY
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Dept. of IInd Surgery, Kurume University, School of Medicine Toshimichi Nakayama, Koji Yoshida, Akio Ikeda, Shigenori Kobayashi, Michihiro Koga |
Extra-hepatic bile ducts and intra-hepatic duct to 2nd generation of branches were excised completely with lymphonods which were suspected to be involved. Reconstruction of bile duct consisted of hepatocholangiojejunostomy more than two sites with simple single layer stiches by the mean of Roux-Y.
It was possible to remove the tumor completely in 4 cases of papillary type and 1 case of nodular type. But it was impossible in each one cases of nodular type, infiltrative nodular type, and diffusedly infiltrative type.
Early death did'nt occured but late death occured in one case of papillary type in 6th month after surgery because of some other reason. Other 7 patients are doing well and the longest survival is 2 years and 2 months now.
Surgical removal of the junctional carcinoma without hepatectomy could be applied to the cases whose papillary or nodular lesion is quite localized at the common hepatic duct or even slightly infiltrative to the left or right hepatic duct.
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