CLINICOPATHOLOGICAL FEATURES OF RESECTED HILAR CARCINOMA OF THE BILE DUCT

Abstract

Between 1983 and 1992, surgical intervention was attempted in 14 patients with hilar carcinoma of the bile duct. Local excision of the lesion alone was performed in four patients and hepatic resection in 10, in nine of whom resection of the caudate lobe was also undertaken. The histological free margin was observed in only five of 10 patients with hepatic resection (microscopic curative resection rate, 35.7%). The positive rate of surgical margins was 21% on the duodenal side, 36% on the resected side, 50% on the hepatic side and 21% on the paraaortic lymph-nodes. The modified Bismuth-Corlette classification was useful for selection of the type of surgical intervention in hilar carcinoma of the bile duct. It is suggested that rational resection of the bile duct including hepatectomy and extensive lymphadenectomy is necessary for widening the radical resection and to improve the surgical outcome of hilar carcinoma of the bile duct.