Carcinoma in the supra-ampullary portion of the bile ducts.

Thirty-four patients with carcinoma of the extrahepatic bile ducts were reviewed and the tumors grouped for surgical evaluation by anatomic locations. Diagnostic techniques of endoscopic retrograde cholangiography and percutaneous transhepatic cholangiography with the Chiba needle as well as angiography have made preoperative diagnosis and evaluation much more accurate. Of 27 patients who fell into the category of supra-ampullary bile duct carcinoma, 12 underwent surgical resection without an operative mortality. Long term results were discouraging, only five patients being described as having actual or potential cures. More aggressive surgical approaches to supra-ampullary carcinoma of the bile ducts offer some expectation of longer palliation and occasional cure.