J.Jpn. Surg. Soc.. 81(8): 782-790, 1980

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Original article

THE STUDY ON SURGICAL PROCEDURE FOR UPPER BILE DUCT CARCINOMA INVESTIGATING FROM RADIOLOGICAL FINDINGS

The growth of bile duct carcinoma was mostly found to be infiltrative directly along the wall, so that it is very difficult to grasp the range of infiltration during operation. It is very important to decide the surgical procedure before the operation. Therefore, the radiological findings of upper bile duct carcinoma were studied in detail. We tried to make a new radiological classification about the location of carcinoma occupation as follows.
Group I. The carcinoma located at common hepatic duct.
Group II. The carcinoma located at the region of hilus of the bile duct.
Group III. The carcinoma involved over second biforcation of right or left intrahepatic bile duct.
Group IV. The carcinoma involved over second biforcation of bilateral intrahepatic bile duct carcinoma.
We divided the obstructive or stenotic feature of bile duct radiologically into 3 types, there are Tumorous type, U-type and V-type. We tried to study on relationship between this classification and the length of pathological extension to proximal bile duct. Pathological extension of the Tumorous type were almost localized, but U-type and V-type were both infiltrative. The mean length of proximal extension of U-type was 7 mm, and V-type was 24 mm. In group I and II, tumorous type is indicated for extrahepatic bile duct resection, but U-type and V-type are indicated for hepatic resection. In group III, hepatic resection should be carried out in any type of radiological feature. In group IV, there is no indication of curative resection.

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