[Treatment of proximal biliary duct carcinoma]

During the past 30 years, 21 patients suffering from proximal biliary duct carcinoma were treated by surgery. The resectability rate was 14%. Three patients had radical resection, 2 surgical bypass, 3 surgical catheterization for drainage, 4 PTCD, and 2 intraluminal radiotherapy with Iridium-192 delivered by a remote afterloading system through catheters introduced intraoperatively. The survivals ranged from 3 to 13 months. Due to the proximity of this portion of biliary duct to the hepatic hilus, invasion of the adjacent structures such as the portal vein and hepatic artery is common. Hence, complete resection is difficult and palliative surgical approach is usually adopted. Results of our treatment and review of relevant documents are presented.