J.Jpn. Surg. Soc.. 87(9): 1090-1093, 1986

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Report on the annual meeting

PROBLEMS IN THE SURGICAL TREATMENT OF CARCINOMA OF THE EXTRAHEPATIC BILE DUCT

One hundred and twenty-six patients with carcinoma of the extrahepatic bile duct were treated at the Nagasaki University Hospital during the past 16 years. Among 126 patients, 61 (48.5%) had tumors involving or close to the hepatic hilum. In the 61 patients, the operative mortality rate was higher, the resectability rate and the cumulative 5 year survival rate lower than in the other patients. It is clear that early diagnosis and curative resection in the patients with tumors of the hilum of the liver is the key to an improvement of results in the treatment of primary bile duct carcinoma. It is suggested that it may be possible to make an early diagnosis of such tumors by some symptoms before jaundice appearing, by elevation of serum alkaline phosphatase, CEA and CA19－9, and by findings of dilated intrahepatic bile ducts and obstruction at the confluence of the hepatic ducts by means of ultrasound, ERC and PTC. The factors of non-curative resections were almost all carcinomatous invasion of the cut stump of the resected specimen. Even in patients who underwent curative resection, local recurrence rate was high. Therefore, postoperative adjuvant treatment of both chemo- and radiotherapy seems mandatory.

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