Abstract
From 1979 to 1990, 56 patients with bile duct carcinoma of the hepatic hilus underwent curative operation, that is, various hepatic segmentectomies based on a thorough understanding of the anatomical features of the hepatic hilus and precise preoperative diagnosis of mode and extent of cancer involvement. The rationale for our surgical procedures was assessed retrospectively from the viewpoint of surgical curability and postoperative quality of life (QOL).Postoperative hospital mortality, because of hepatic failure, was 11%.Five-year survival rates for all 56 patients and 43 patients excluding those who died of causes other than recurrent cancer were 32% and 43%, respectively. The long-term results are good, even though the majority of our cases were in the advanced stage.QOL in 15 patients surviving more than 1 year without cancer recurrence has been evaluated.Performance status (PS) was 0 in 14 patients and 1 in only one.All 10 patients who had jobs before surgery could return to their original occupations.Only 3 patients (20%) have shown some mild symptoms of transient cholangitis.We emphasize that our rationale for hepatic segmentectomy provides not only surgical cure but also satisfactory QOL after surgery.
