Skip to main content
PMC home page
Annals of Surgery logoLink to Annals of Surgery
. 1981 Oct;194(4):447–457. doi: 10.1097/00000658-198110000-00008

Prognostic factors in bile duct carcinoma: analysis of 96 cases.

R K Tompkins, D Thomas, A Wile, W P Longmire Jr
PMCID: PMC1345321  PMID: 7283506

Abstract

A computerized analysis of prognostic variables was performed in 96 proven cases of extrahepatic bile duct carcinoma treated over a 24-year period at UCLA. Forty-nine percent of the lesions were in the upper third of the bile ducts and 47% of these were resected, for an operative mortality rate of 23% and a maximum survival rate of 4.5 years. Palliative procedures in this region were associated with a 16% mortality rate and maximum survival rate of three years. The patients whose lesions were in the middle third suffered no operative mortality rate for resection or palliation and had a 12% five-year survival rate, with the longest survivor lasting 11 years. In the lower third lesions, 67% were resected by Whipple's procedures, for an 8% mortality rate and a five-year survival rate of 28% extending to nine years. Resection of these difficult carcinomas offers the best hope of survival but must be weighed against the high operative mortality risk in those lesions located in the hilar region.

Full text

PDF
447

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Akwari O. E., Kelly K. A. Surgical treatment of adenocarcinoma. Location: junction of the right, left, and common hepatic biliary ducts. Arch Surg. 1979 Jan;114(1):22–25. doi: 10.1001/archsurg.1979.01370250024004. [DOI] [PubMed] [Google Scholar]
  2. 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]
  3. Cohn I., Jr Presidential address: Gastrointestinal cancer. Surgical survey of abdominal tragedy. Am J Surg. 1978 Jan;135(1):3–11. doi: 10.1016/0002-9610(78)90002-8. [DOI] [PubMed] [Google Scholar]
  4. Evander A., Ihse I., Lunderquist A., Tylén U., Akerman M. Percutaneous cytodiagnosis of carcinoma of the pancreas and bile duct. Ann Surg. 1978 Jul;188(1):90–92. doi: 10.1097/00000658-197807000-00015. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. 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]
  6. Ingis D. A., Farmer R. G. Adenocarcinoma of the bile ducts. Relationship of anatomic location to clinical features. Am J Dig Dis. 1975 Mar;20(3):253–261. doi: 10.1007/BF01070728. [DOI] [PubMed] [Google Scholar]
  7. Launois B., Campion J. P., Brissot P., Gosselin M. Carcinoma of the hepatic hilus. Surgical management and the case for resection. Ann Surg. 1979 Aug;190(2):151–157. doi: 10.1097/00000658-197908000-00005. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Lees C. D., Zapolanski A., Cooperman A. M., Hermann R. E. Carcinoma of the bile ducts. Surg Gynecol Obstet. 1980 Aug;151(2):193–198. [PubMed] [Google Scholar]
  9. 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]
  10. Maram E. S., Ludwig J., Kurland L. T., Brian D. D. Carcinoma of the gallbladder and extrahepatic biliary ducts in Rochester, Minnesota, 1935--1971. Am J Epidemiol. 1979 Feb;109(2):152–157. doi: 10.1093/oxfordjournals.aje.a112670. [DOI] [PubMed] [Google Scholar]
  11. Neugebauer W., Durst J., Mayer H. R. Das primäre Carcinom der extrahepatischen Gallenwege. Langenbecks Arch Chir. 1979 Nov;350(1):33–42. doi: 10.1007/BF01232093. [DOI] [PubMed] [Google Scholar]
  12. Pilepich M. V., Lambert P. M. Radiotherapy of carcinomas of the extrahepatic biliary system. Radiology. 1978 Jun;127(3):767–770. doi: 10.1148/127.3.767. [DOI] [PubMed] [Google Scholar]
  13. 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]
  14. Terblanche J. Carcinoma of the proximal extrahepatic biliary tree. Definitive and palliative treatment. Surg Annu. 1979;11:249–265. [PubMed] [Google Scholar]
  15. Tompkins R. K., Johnson J., Storm F. K., Longmire W. P., Jr Operative endoscopy in the management of biliary tract neoplasms. Am J Surg. 1976 Aug;132(2):174–182. doi: 10.1016/0002-9610(76)90044-1. [DOI] [PubMed] [Google Scholar]

Articles from Annals of Surgery are provided here courtesy of Lippincott, Williams, and Wilkins

RESOURCES