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. 1987 Feb;205(2):111–118. doi: 10.1097/00000658-198702000-00001

Proximal bile duct cancer. Quality of survival.

E C Lai, R K Tompkins, L L Mann, J J Roslyn
PMCID: PMC1492831  PMID: 2434042

Abstract

A retrospective study of 97 patients with proximal bile duct cancer treated at the University of California, Los Angeles Medical Center was conducted to determine the benefits of different operative treatments. Eighty-nine patients were divided into three treatment groups: Group I, curative resection (29 patients); Group II, palliative resection (13 patients) and bypasses (8 patients); and Group III, operative intubation (39 patients). Two patients died before operation and six patients were treated without operation by percutaneous biliary decompression. High morbidity rate (53.8%) and mortality rate (69.2%) were encountered in 13 patients who had hepatic resection. Survival rates of the three treatment groups were comparable. For the 64 patients closely monitored after discharge, quality of survival was assessed according to six parameters: frequency of hospitalization for cholangitis; catheter-related problems; the percentage of days hospitalized; duration of jaundice; antibiotic requirements; and analgesic needs. Group I patients had the best qualitative survival, whereas Group II patients had the worst result when compared with either Group I (p less than 0.001) or Group III (p less than 0.005). Curative resection is recommended when it can be done without a concomitant hepatic resection. When noncurable disease is found on examination, operative intubation after dilatation is the preferred palliative measure.

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Selected References

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

  1. ALTEMEIER W. A., GALL E. A., ZINNINGER M. M., HOXWORTH P. I. Sclerosing carcinoma of the major intrahepatic bile ducts. AMA Arch Surg. 1957 Sep;75(3):450–461. doi: 10.1001/archsurg.1957.01280150140015. [DOI] [PubMed] [Google Scholar]
  2. Alexander F., Rossi R. L., O'Bryan M., Khettry U., Braasch J. W., Watkins E., Jr Biliary carcinoma. A review of 109 cases. Am J Surg. 1984 Apr;147(4):503–509. doi: 10.1016/0002-9610(84)90013-8. [DOI] [PubMed] [Google Scholar]
  3. Beazley R. M., Hadjis N., Benjamin I. S., Blumgart L. H. Clinicopathological aspects of high bile duct cancer. Experience with resection and bypass surgical treatments. Ann Surg. 1984 Jun;199(6):623–636. doi: 10.1097/00000658-198406000-00001. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Blumgart L. H., Hadjis N. S., Benjamin I. S., Beazley R. Surgical approaches to cholangiocarcinoma at confluence of hepatic ducts. Lancet. 1984 Jan 14;1(8368):66–70. doi: 10.1016/s0140-6736(84)90002-3. [DOI] [PubMed] [Google Scholar]
  5. Evander A., Fredlund P., Hoevels J., Ihse I., Bengmark S. Evaluation of aggressive surgery for carcinoma of the extrahepatic bile ducts. Ann Surg. 1980 Jan;191(1):23–29. doi: 10.1097/00000658-198001000-00005. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Ferrucci J. T., Jr, Mueller P. R., Harbin W. P. Percutaneous transhepatic biliary drainage: technique, results, and applications. Radiology. 1980 Apr;135(1):1–13. doi: 10.1148/radiology.135.1.7360943. [DOI] [PubMed] [Google Scholar]
  7. 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]
  8. Hansson J. A., Hoevels J., Simert G., Tylén U., Vang J. Clinical aspects of nonsurgical percutaneous transhepatic bile drainage in obstructive lesions of the extrahepatic bile ducts. Ann Surg. 1979 Jan;189(1):58–61. doi: 10.1097/00000658-197901000-00012. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Hart M. J., White T. T. Central hepatic resection and anastomosis for stricture or carcinoma at the hepatic bifurcation. Ann Surg. 1980 Sep;192(3):299–305. doi: 10.1097/00000658-198009000-00004. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. KLATSKIN G. ADENOCARCINOMA OF THE HEPATIC DUCT AT ITS BIFURCATION WITHIN THE PORTA HEPATIS. AN UNUSUAL TUMOR WITH DISTINCTIVE CLINICAL AND PATHOLOGICAL FEATURES. Am J Med. 1965 Feb;38:241–256. doi: 10.1016/0002-9343(65)90178-6. [DOI] [PubMed] [Google Scholar]
  11. 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]
  12. Malangoni M. A., McCoy D. M., Richardson J. D., Flint L. M. Effective palliation of malignant biliary duct obstruction. Ann Surg. 1985 May;201(5):554–559. doi: 10.1097/00000658-198505000-00003. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Molnar W., Stockum A. E. Relief of obstructive jaundice through percutaneous transhepatic catheter--a new therapeutic method. Am J Roentgenol Radium Ther Nucl Med. 1974 Oct;122(2):356–367. doi: 10.2214/ajr.122.2.356. [DOI] [PubMed] [Google Scholar]
  14. Takasan H., Kim C. I., Arii S., Takahashi S., Uozumi T., Tobe T., Honjo I. Clinicopathologic study of seventy patients with carcinoma of the biliary tract. Surg Gynecol Obstet. 1980 May;150(5):721–726. [PubMed] [Google Scholar]
  15. Tompkins R. K., Thomas D., Wile A., Longmire W. P., Jr Prognostic factors in bile duct carcinoma: analysis of 96 cases. Ann Surg. 1981 Oct;194(4):447–457. doi: 10.1097/00000658-198110000-00008. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Tsuzuki T., Ogata Y., Iida S., Nakanishi I., Takenaka Y., Yoshii H. Carcinoma of the bifurcation of the hepatic ducts. Arch Surg. 1983 Oct;118(10):1147–1151. doi: 10.1001/archsurg.1983.01390100021006. [DOI] [PubMed] [Google Scholar]
  17. Tsuzuki T., Uekusa M. Carcinoma of the proximal bile ducts. Surg Gynecol Obstet. 1978 Jun;146(6):933–943. [PubMed] [Google Scholar]

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