Surgical resection for hepatoportal bile duct cancer

AIM:To discuss the effect of surgical procedures on the prognosis of patients of bile duct cancer and their indications.METHODS:A retrospective analysis was made for 52 cases of hepatoportal bile duct cancer treated from January 1991 to December 1996. All the cases were classified according to the modified Bismuth-Corlettle system and received appropriate operation. Therapeutic effects were evaluated on the basis of their survival rates,jaundice elimination, comfort index,operative mortality and complications.RESULTS:Seventeen cases received surgical resection (32.7%). The survival rate was 71.4%, 35.7% and 10.4% for one, two and three years respectively, and was 30%, 16.8% and 0% for those with drainage (P < 0.05).The mortality rate was 6.0% for the drainage group and 5.9% for the resection group (P > 0.05). Of the 17 resected patients,8 (47.1%) had curative resection and 9 (52.9%) noncurative resection. Their mean survival time was 21.1 months and 7.5 months respectively (P < 0.05).CONCLUSION:Proper surgical procedure should be used on the basis of the local and general conditions of the patients, and aggressive resection with or without liver resection is a valid procedure for the treatment of hepatoportal bile duct cancer and can significantly improve the prognosis of patients.