The primary carcinoma of the extrahepatic bile duct is an infrequent tumor which is associated with an extremely grave prognosis.
In the present article are described the clinical experience of 32 patients of bile duct cancer treated at the Department of Surgery of Kyungpook National University Hospital during 10 years period between 1963 and 1973. The diagnosis was made at laparatomy and confirmed histologically. Follow up could be made in 13 cases -after various forms of both palliative and curative surgical procedures.
Results of the study are summarized, as follows:
1. Distribution of age was most prevalent in 5th decade and male to female ratio was 3 : 1.
2. Presenting complaint of most patients was jaundice and one half complained also pain and dyspepsia. Anorexia, weight loss, fever and chill and pruritis made up the rest of the ysmptomatology.
3. The test of liver function and findings of physical examination were similar to those in any patient with bile duct obstruction and the most valuable diagnostic procedure. was proved to be percutaneous transhepatic cholangiography.
4. Carcinoma of the bile duct occured in all portions of the biliary tree, but was most commonly found in its midportion. It´s rapid submucosal spread and metastasis to the regional lymph nodes and adjacent structures made the surgical resection for cure so hard that only 3 pancreaticoduodenectomy could be accomplished among the patients who had. distal lesions.
5. Average survival , period of pancreaticoduodenectomy was 12.6 months and that of decompressive procedures of internal drainage was 12. months. Although either pancreaticod uodenectomy or palliative drainage surgery could not obtain the curable result, worthwhile prolongation of life up to 24 months had been accomplished in I case of choledochojejunostomy.
Palliative bypassing or dilation and intubation were worthwhile for the relief of pruritis and jaundice.
6. Histologically, all of the cancer of the extrahepatic biliary tract was adenocarcinoma.
7. The wound infection was most frequent postoperative complication, and total postoperative complication rate was 31%.
8. The operative mortality rate was 12%.
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