Abstract
Tumor resection for treatment of carcinoma of the hepatic hilus was preferred over routine palliative decompression at the University Hospital Center, Rennes, France, in 1974. Since then, resection has been performed on 18 patients. In seven of these patients resection proved impractical because of the extension of a neoplasm into the portal vein or liver, therefore palliative decompression was performed. In 11 patients (61%) tumor resection, followed by reconstruction of the biliary tree, was performed successfully. All the resected tumors were adenocarcinomas of the proximal bile ducts. Four patients had simple hepatic duct resection. In two patients duct resection was associated with right lobectomy, in three patients with left lobectomy, in one patient with segmentectomy, and in one patient with excision of the right branch of the hepatic artery. There were two postoperative deaths. The mean survival time for the remaining nine patients is 521 days. Five patients were alive in August 1978, at intervals ranging from 175 to 1180 days after resection. These results contrast favorably with those obtained between 1968 and 1973, during which period nine patients had palliative decompression, with three postoperative deaths and a mean survival time of 164 days for the remaining six patients.
Full text
PDF






Images in this article
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Alexandre J. H., Petite J. P., Germain M., Chevalley J., Poilleux F. Chirurgie d'exérèse dans les cancers des canaux biliaires intra-hépatiques. Chirurgie. 1973 May 2;99(6):356–363. [PubMed] [Google Scholar]
- Andersson A., Bergdahl L., van der Linden W. Malignant tumors of the extrahepatic bile ducts. Surgery. 1977 Feb;81(2):198–202. [PubMed] [Google Scholar]
- BROWN G. Surgical removal of tumors of the hepatic ducts. Postgrad Med. 1954 Aug;16(2):79–85. doi: 10.1080/00325481.1954.11712287. [DOI] [PubMed] [Google Scholar]
- Bertrand L., Prioton J. B., Ciurana A. J. Le cancer du confluent biliaire supérieur, dit "du hile". Presse Med. 1970 May 30;78(27):1213–1218. [PubMed] [Google Scholar]
- Bismuth H., Corlette M. B. Intrahepatic cholangioenteric anastomosis in carcinoma of the hilus of the liver. Surg Gynecol Obstet. 1975 Feb;140(2):170–178. [PubMed] [Google Scholar]
- Couinaud C. Cholangio-jéjunostomies intra-hépatiques gauches. A propos de 18 observations personnelles. Arch Fr Mal App Dig. 1967 Apr;56(4):295–310. [PubMed] [Google Scholar]
- DOGLIOTTI A. M., FOGLIATI E. Resection of the liver with intrahepatoductogastrostomy or intrahepatoductojejunostomy for biliary obstruction. J Int Coll Surg. 1956 Sep;26(3):267–274. [PubMed] [Google Scholar]
- Fortner J. G., Kallum B. O., Kim D. K. Surgical management of carcinoma of the junction of the main hepatic ducts. Ann Surg. 1976 Jul;184(1):68–73. doi: 10.1097/00000658-197607000-00012. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Guillemin G., Dubois J., Braillon G., Cuilleret J. Valeur et indications des dérivations cholangio-jéjunales intra-hépatiques dans la chirurgie de l'ictère par rétention. A propos de neuf observations. Mem Acad Chir (Paris) 1965 May 12;91(15):484–488. [PubMed] [Google Scholar]
- Hepp J., Moreaux J., Lechaux J. P. Les anastomoses bilio-digestives intrahépatiques dans les cancers des voies biliaires. Résultats de 62 interventions. Nouv Presse Med. 1973 Jul 7;2(27):1829–1832. [PubMed] [Google Scholar]
- Iwasaki Y., Ohto M., Todoroki T., Okamura T., Nishimura A. Treatment of carcinoma of the biliary system. Surg Gynecol Obstet. 1977 Feb;144(2):219–224. [PubMed] [Google Scholar]
- Le Neel J. C., Leborgne J., Mousseau P. A., Le Neel N., Visset J. Cancers de la voie biliaire principale. Problemes Diagnostiques et therapeutiques a propos de 20 cas. Med Chir Dig. 1973;2(5):295–300. [PubMed] [Google Scholar]
- Longmire W. P., McArthur M. S., Bastounis E. A., Hiatt J. Carcinoma of the extrahepatic biliary tract. Ann Surg. 1973 Sep;178(3):333–345. doi: 10.1097/00000658-197309000-00013. [DOI] [PMC free article] [PubMed] [Google Scholar]
- PACK G. T., MOLANDER D. W. Metabolism before and after hepatic lobectomy for cancer. Studies in twenty-three patients. Arch Surg. 1960 Apr;80:685–692. doi: 10.1001/archsurg.1960.01290210153030. [DOI] [PubMed] [Google Scholar]
- Ragins H., Diamond A., Meng C. H. Intrahepatic cholangiojejunostomy in the management of malignant biliary obstruction. Surg Gynecol Obstet. 1973 Jan;136(1):27–32. [PubMed] [Google Scholar]
- Ross A. P., Braasch J. W., Warren K. W. Carcinoma of the proximal bile ducts. Surg Gynecol Obstet. 1973 Jun;136(6):923–928. [PubMed] [Google Scholar]
- SOUPAULT R., COUINAUD C. Sur un procédé nouveau de dérivation biliaire intra-hépatique: les cholangio-jéjunostomies gauches sans sacrifice hépatique. Presse Med. 1957 Jun 22;65(50):1157–1159. [PubMed] [Google Scholar]
- Terblanche J. Is carcinoma of the main hepatic duct junction an indication for liver transplantation or palliative surgery? A plea for the U tube palliative procedure. Surgery. 1976 Feb;79(02):127–128. [PubMed] [Google Scholar]
- Wanebo H. J., Grimes O. F. Cancer of the bile duct: the occult malignancy. Am J Surg. 1975 Aug;130(2):262–268. doi: 10.1016/0002-9610(75)90381-5. [DOI] [PubMed] [Google Scholar]