Clinical Articles
Copyright ©The Author(s) 1996. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Mar 25, 1996; 2(1): 27-29
Published online Mar 25, 1996. doi: 10.3748/wjg.v2.i1.27
Studies on surgical operations and prognosis of extrahepatic bile duct cancer
Yue-Zu Fan, Tong-Nian Cai, Bao-Chang Wang
Yue-Zu Fan, Tong-Nian Cai, Bao-Chang Wang, Department of Surgery, Affiliated Ganquan Hospital, Medical College of Shanghai Railway University, Shanghai 200065, China
Author contributions: All authors contributed equally to the work.
Correspondence to: Dr. Yue-Zu Fan, Ganquan Hospital, Medical College of Shanghai Railway University, 389 Xinchun Road, Shanghai 200065, China
Telephone: +86-21-56051080-1107
Received: January 1, 1996
Revised: January 31, 1996
Accepted: February 10, 1996
Published online: March 25, 1996

AIM: To perform a clinical evaluation of the surgical procedures of extrahepatic bile duct cancer and their influence on prognosis.

METHODS: A total of 55 patients with pathologically and clinically verified extrahepatic bile duct cancer treated in our department between January 1984 and December 1993 were analyzed retrospectively. Clinical courses, with respect to the surgical procedures, investigated by follow-up and the survival period was assessed.

RESULTS: Among the 55 patients, 24 received surgery that involved the upper third of extrahepatic biliary tract, 12 involving the middle third, and 19 involving the lower third. The diagnosis of bile duct cancer was confirmed histopathologically in 42 of the patients, with a clear predominance of adenocarcinoma (97.6%). Eleven (26.2%) of the patients received curative resection, 30 received palliative procedures (i.e. biliary-enteric bypass (n = 14) and external drainage (n = 16)), 6 received permanent percutaneous transhepatic cholangio-drainage (PTCD) alone, and 8 received exploratory laparotomy only or conservative treatment. Forty-eight patients (87.3%) were followed-up. The overall mean survival period was 10.8 ± 9.7 mo (¯x ± s); patients with curative resection had the longest survival period (21.4 ± 16.7 mo, P < 0.01) and highest survival rate (P < 0.05). A significant survival difference was observed for patients with biliary-enteric anastomosis as compared with those who had external drainage, etc. (P < 0.05), but there was no significant difference in survival period between patients who had preoperative PTCD (n = 23) and those who did not (n = 26) (P < 0.05).

CONCLUSION: Curative resection is the treatment of choice for suitable patients with extrahepatic bile duct cancer; biliary-enteric anastomosis is preferable for those with unresectable tumor in order to improve prognosis and quality of life.

Keywords: Bile duct neoplasms/surgery, Prognosis, Portoenterostomy, Hepatic