Abstract
We treated 39 cases of bile duct cancer from 1974 to 1987. The lesion was found in the superior portion of the bile duct in 20 cases, middle portion in eight and inferior portion in nine. Resection was performed in 20 of the 39 cases (51%). In detail, seven (35%) of the cases with superior portion cancer, six (75%) of the cases with middle portion cancer and seven (70%) of the cases with inferior portion cancer underwent resection. Surgery was curative in ten of the 20 cases (50%). These ten cases consisted of five with middle portion cancer and five with inferior portion cancer. In cases with superior portion cancer, surgery was non-curative, and consequently, the survival rate was lower than that for cases with middle and inferior portion cancers. These results were interpreted as follows: The pancreatoduodenostomy were performed in cases with middle and inferior portion cancers, yielding favorable results. In cases with superior portion cancer, the bile duct at the porta hepatis was resected, and the surgery was non-curative in many cases because of not only retention of cancer in the hepatic side stump of the bile duct but also infiltration in the serous membrane side. It was suggested that extensive cholangectomy with resection of the liver and partial resection of portal vein and hepatic artery was necessary to improve results of treatment for bile duct cancer. Further, usefulness of external irradiation in patients not receiving resection of bile duct cancer was discussed.
