[Surgical treatment of hilar bile duct carcinoma]

Carcinoma of the bile duct at the hepatic hilar region is not a rare condition but with a low resectability rate. The incidence of this disease seems to be on increasing. In a previous report, 60 cases were explored surgically from 1975 to 1985, but resection was only possible in 5 cases (9.1%); while in the recent years from June, 1986 to June 1989, 24 cases were explored in the Surgical Department of General Hospital of PLA, 16 cases were resected, with a resectability rate of 66%. The increase of resectability rate was due to earlier recognition of this condition and the extension of surgery, including major resection of liver as well as radical dissection of the hepato-duodenal ligament and reparative operations on the blood vessels. Among these 16 cases, major hepatic resection was performed in 10 cases, in which, 3 cases of resections of the middle lobe of the liver were done instead of right or extended right lobectomy. No operative mortality in the 30 days' postoperative period, but the postoperative morbidity rate was still high and most of the complications were related to biliary leakage and infect ion. Three patients died in the postoperative follow up period at 6.14 and 15 months respectively. All of them died from biliary infection. The remaining 13 patients were still living, the longest being 40 months and the average living time was 16.1 months. Probably, lowering of the operative mortality rate and morbidity rate are still the most important considerations in the surgical treatment of hilar carcinoma at the present time.(ABSTRACT TRUNCATED AT 250 WORDS)