Clinicopathologic analysis of primary lesions of biliary malignancies caused stricture of the proximal bile duct and clinical characteristics of possible primary cancer of the cystic duct

Abstract

We had 10 patients with stricture of the proximal bile duct caused by biliary malignancies. From their operative findings and histopathologic aspects of the specimens resected, it was considered to be reasonable that 2 of the 10 were diagnosed as primary bile duct cancer arisen from the superior portion of the bile duct,2 were arisen from the middle portion and the other six from the cystic duct. None of the 6 patients with primary cancer of the cystic duct conformed to Farrar's criteria. Distension of the gallbladder was demonstrated by CT and US in the 6 patients without exception but in the other 4 the gallbladder showed atrophic. At the time of appearance of jaundice, extension of the tumors in the 6 was extremely more progressive than that in the 4, and the route of the tumor extension in the former ones differed from that in the latters.