Operative results of extrahepatic bile duct carcinoma.

To determine the benefits of surgical treatment for patients with carcinoma of the extrahepatic bile duct, data on 100 patients with this disease who had been surgically treated in our clinic during the past 18 years were evaluated. These patients were grouped into three, i.e., upper, middle and lower bile duct groups. Patients with periampullary tumor were excluded from this study. Surgical procedures consisted of resection of the tumor, including hepatic resection and dissection of the regional lymph nodes, and a bypass operation of the extra- or intrahepatic bile duct. Resectability rates of the tumor were 21.6% in upper, 82.4% in middle, and 50% in lower bile duct groups. Average survival times of patients who had a resection of the tumor were 30.3 months in the upper bile duct group, 35.9 months in middle (the longest, 13 years and 3 months) and 22.5 months in lower bile duct group. Survival rates of overall patients with resection of tumors were 64.5% at one year, 29.0% at 3 years, and 12.9% at 5 years after surgery, respectively. The middle bile duct group showed the most favorable operative results of all the groups, an extended resection of the tumor should be carried out to obtain for a longer survival.