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Carcinoma of the extrahepatic biliary tree: analysis of 15 cases
F J Mena1, R Velicia, M C Valbuena
1Department of Gastroenterology: "Rio Hortega" University Hospital, Vlladold, Spain.
Aim:
to analyze the epidemiology, prognosis and treatment of those diagnosed as having cholangiocarcinoma of the extrahepatic biliary tree.
Methods:
a prospective study including all cases diagnosed over a period of 26 months. Fifteen patients with primary bile duct carcinoma were included.
Results:
the incidence rate was 3.23 cases/10(4). The tumor locations were: 40% proximal bile duct, 33% distal bile duct, and 27% mid-duct. The treatments used were: curative resection in 1 case (7%); palliative surgery in 3 cases (20%); internal drainage through a prosthetic biliary stent by endoscopic retrograde cholangiopancreatography in 6 cases (40%) and by percutaneous transhepatic cholangiography in 2 cases (13%); external bile drainage in case (7%), and in the remaining 2 patients (13%) no treatment was possible. The 1-month, 6-month and 10-month survival rates were 67%, 40% and 33% respectively. Factors associated with a worse survival in this study were age over 70 years and female sex. The worst prognostic location was the mid-duct compared to the distal and proximal thirds.
Conclusions:
the incidence of the primary bile duct carcinoma is high in our population. The commonest location is the proximal bile duct. Curative surgical resection is possible in only a few cases, and thus the overall prognosis is very bad.