J.Jpn. Surg. Soc.
ISSN 1880-1129

[Abstract] [Full Text PDF] （in Japanese / 1719KB） [Members Only And Two Factor Auth.]

J.Jpn. Surg. Soc.. 100(2): 195-199, 1999

Feature topic

TREATMENT OF RECURRENT CANCER AFTER SURGERY FOR BILIARY MALIGNANCIES

1) The First Department of Surgery, Nagoya University School of Medicine, Nagoya, Japan
2) Department of Surgery, Kasugai Municipal Hospital, Kasugai, Japan
3) Department of Surgery, Tokai Hospital, Nagoya, Japan
4) Department of Surgery, Anjo Kosei Hospital, Anjo, Japan

Katsuhiko Uesaka1), Junichi Kamiya1), Masato Nagino1), Norihiro Yuasa1), Tsuyoshi Sano1), Koji Oda1), Michio Kanai2), Naokazu Hayakawa3), Hideo Yamamoto3), Shunpei Yokoi4), Yuji Nimura1)

Our strategy for recurrent tumor after surgical resection for biliary malignancies, especially for hilar cholangiocarcinoma, is described. One hundred and thirty-three patients with hilar cholangiocarcinoma underwent curative resection in our department until November, 1998, and recurrent carcinomas have been pointed out in 73 patients (54.9％). The site of recurrence was peritoneum (21 cases), liver (16 cases), pre-caval and retro-duodenal space (15 cases), hepatic hilum (11 cases), lymph node (9 cases ), bone(6 cases), sinus tract of percutaneous transhepatic biliary drainage (PTBD) (5 cases) and so on.
Surgical resection was applied to recurrent carcinomas after careful evaluation, and 9 patients underwent surgical resection of the recurrent tumor : sinus tract of PTBD in the abdominal and/or chest wall (4 cases), lymph node (2 cases), liver (1 case), hepaticojejunostomy (1 case) and duodenum (1 case). There were three hospital death patients. Other six patients survived for 16 months on an average (11-20 months) after surgery for recurrent tumor.
PTBD for recurrent cancer at the hepatic hilum and gastrojejunostomy for local recurrence around the duodenum improved quality of life of patients. Radiation therapy for bone metastasis or local recurrence at the hepatic hilum was sometimes very effective. Effect of systemic or transarterial chemotherapy is still unknown.

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