Primary cancer of the extrahepatic bile duct is classified according to its anatomical location as upper, middle, and distal. In general, among them distal bile duct cancer has the best prognosis due to the highest resectability rate. Yet, the
only
lesion that is expected to be cured is limited to the early bile duct cancer. Therefore, earlier recognition and treatment with resection will be necessary to increase survival rates. A retrospective analysis was conducted in 17 patients with
distal
bile dust cancer managed at our hospital during 2 year-period(1989. 6~1991.5).
@ES The results were as follows;
@EN 1) The incidence of the distal bile duct cancer among the extrahepatic bile duct cancers and among the periampullary cancers was 44.7% and 37.0%, respectively.
2) The most common age group was in the 7th decade and male to female ratio was 3.25:1.
3) The most common clinical manifestation was jaundice and there were 5 patients who showed the symptoms and signs of acute cholangitis.
4) Among the laboratory findings, almost all patients showed abnormal liver function, especially in SGOT, SGPT, alkaline phosphatase, and total bilirubin.
5) By the use of diagnostic tools, the preoperative diagnosis were made in 15 patients (88.2%).
6) As for the oeprative treatment, we performed Whipple procedure in 13 total pancreatectomy in 1 with 82.4% of the resectability rate.
7) Histopathologically, most of the lesions were infiltrative type(88.2%) and diagnosed as adenocarcinoma(93.8%).
8) According to the TNM staging, AJCC, 1988, stage IV lesions were most common (47%).
9) There were 2 cases of postoperative death(mortality rate:11.8%), on was following Whipple procedure-stage IVA and the other following biopsy only-stage IVB. Accordingly, operative mortality after resection was 7.1% and 33.3% in non-resected
group.
10) In our cases, the OPD follow-up after treatment was not long enough to make any statement about the long-term results, nevertheless, there were 4 cases of death with their mean survival time of 11.4 months(stage III-14 months, stage IVA-8.8
months)
11) .
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