Abstract
There are 284 resected cases with malignant tumor of the liver, the biliary tract and the pancreas at our hospital for 12 years. Average prognosis is 8 months and the resectability is 21.1%.
In detail, there are 47 cases of the liver tumor (8 resected cases, resectability 17.0%) 68 cases of carcinoma of the bile duct (18 cases, 29.4%), 52 cases of carcinoma of the gall-bladder (14 resected cases, 26.9%) 11 cases of carcinoma of the papilla of Vater (9 resected cases, 81.8%) and 106 cases of carcinoma of the pancreas (9 resected cases, 8.4%.
Average prognosis of the resected cases and the non-resected cases are shown: liver tumor (37.7 months, 3.6m), carcinoma of the bile duct (18.9m, 5.0m), carcinoma of the gallbladder (9.8m, 5.4m), carcinoma of the papilla of Vater (32.7m, 0.5m) and carcinoma of the pancreas (22.6m, 3.8m): So, resected cases can live longer than non-resected cases.
Twelve months survival rate (Kaplan-Meier's method) shows: liver tumor (hepatocellular hepatoma 11%, cholangiocellular hepatoma 9%), carcinoma of the bile duct (the intrahepatic and the hepatic duct 10%, the distal common bile duct 53%), carcinoma of the gallbladder 8.7%, carcinoma of the papilla of Vater 72%, carcinoma of the pancreas (the head of the pancreas 8%, others 4.8%). So, carcinoma without carcinoma of the distal common bile duct and the papilla of Vater are difficult to have opportunity to live longer than twelve months.
But there are many different cases of long alived resected cases, for example, cases with early stage of the carcinoma are reasonable to live long and a few resected cases living with advanced stage of the remarkable recurrence.
So we should operate the cases as we can. We present the interesting and long-lived cases after the resection. Case 1) 31-years-old female (hepatoma with invasion to the bile duct) reresected the recurrenced tumor in the small omentum 5 years after the initial left liver lobectomy. Now she has been alive for 7 years and 10 months. Case 2) 76 years-old female (carcinoma of the gallbladder) received cholecystectomy for choledocholithiasis. She died of the other disease after 3 years and 4 months. Case 3) 55-years-old female (carcinoma of the papilla of Vater) was found 1.5cm diameter sized tumor localized in the papilla of Vater. Being alive for 6 years and 6 months after the pancreaticoduodenectomy. Case 4) 64-years-old male (carcinoma of the hepatic duct) was found 1.5cm diameter sized tumor like IIa type localized in the hepatic duct. Being alive for 6 years and 8 months after the resection of the bile duct. Case 5) 65-years-old male (carcinoma of the distal common bile duct) was found early carcinoma of the 1.0cm diameter sized tumor localized in the distal common bile duct. Being alive for 7 years and 10 months after the pancreati-coduodenectomy. Case 6) 40-years-old female (carcinoma of the pancreas) received audal pancreatectomy for non-functioning islet cell carcinoma of the tail of the pancreas. Though the remarkable recurrenced sign was noted two years after the operation, she has been alive for 11 years and 6 months after surgery.
