J.Jpn. Surg. Soc.. 91(9): 1241-1244, 1990
Report on the annual meeting
SIGNIFICANCE OF EXTENDED OPERATION FOR BILE DUCT CARCINOMA AT THE HEPATIC HILAR REGION
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The Second Department of Surgery, Nagasaki University School of Medicine, Nagasaki, Japan Tsukasa Tsunoda, Shigeki Tokunaga, Toshifumi Eto, Kunihide Izawa, Ryoichi Tsuchiya, Toshiomi Kusano*), Masato Furukawa*), |
Twenty out of the 39 resected cases received hepatic resection, in which 9 had a combined resection of the caudate lobe of the liver. The procedures employed in the 20 hepatectomies included 2 central hepatic resections, 10 left hepatic lobectomies and 8 extended right hepatic lobectomies. Pathology revealed infiltration of hepatic parenchyma in 64.1%, lymph node metastasis in 43.6%, and invasion to the main vessels in 51.3%. Additional hepatic Iobectomy to an usual bile duct resection significantly increased the rate of tumor-free surgical margin of the hepatic side. The cumulative 3- and 5-year survival rates were 58.2% and 43.7% in the curative resection group (N=17), while 11.4% and 5.7% in the non-curative resection group (N=22). There was a statistical difference between the two groups.
It was suggested that extended resection of the bile duct including hepatectomy, wide lymph node dissection and surrounding vessel resection is of importance to improve the prognosis of bile duct carcinoma at the hepatic hilar region.
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