[Therapy and course of malignant extrahepatic bile duct tumors. Results in 93 cases]

Based on a retrospective study concerning the years 1974 to 1987 93 malignant extrahepatic bile duct tumors are being analyzed with regard to its histology, therapy and time of survival. The cases referred to herein are 49 tumors of the gallbladder and 44 bile duct tumors (25 tumors of the hepatic confluation, 10 tumors of the middle and 9 tumors of the distal portion of the bile duct). The middle and the distal hepatic duct tumors with 15.1 and 14.5 months respectively from the beginning of therapy have the longest time of survival on average. In contrast to those figures there are the bifurcation tumors with 9.9 months and the gallbladder tumors with 6.1 months of survival. So far 3 patients (2 with a gallbladder and 1 with a middle hepatic duct tumor) have survived as long as 3 years and are still alive. Only 1 patient, relating to a time of survival of 5 years, has been cured (gallbladder). 26.5% of these patients needed a second, 9.5% of them a third operation. A lengthy resection with curative intentions was done on 20.4% of the patients. 76.3% were treated palliatively, preferring, whenever possible internal drainage methods such as endoprosthesis or direct anastomosis drainage (hepaticojejunostomy, hepaticoduodenostomy, etc.).