Bile duct carcinoma. Diagnosis and treatment

Fifty-three patients were evaluated for carcinoma of the extrahepatic bile ducts at the University of Virginia from 1951 to April 1984. This population was retrospectively reviewed and 33 preoperative and postoperative variables were analyzed to evaluate the predictors of increased survival. No preoperative data, including symptoms, admitting laboratory data, or tumor location, predicted increased survival. Whipple resection yielded a median survival of 12 months; palliative resections, 1.5 months; and laparotomy, only 5.5 months; these differences were not statistically significant. Experience with six patients treated with internal radiation (iridium-192), plus as much as 4000 rads of external beam irradiation, suggests that this combination of radiation treatment may aid palliation.