[Treatment of cancer of the gallbladder and bile duct]

The records of 166 patients (85 men and 81 women) with extrahepatic bile duct cancers consisted of 58 patients with gallbladder cancer, 76 patients with bile duct cancer, and 32 patients with cancer of the papilla of vater were reviewed. A mean age was 60 years old (ranged: 30-80 years old). Twelve of 58 patients with gallbladder cancer were treated with simple cholecystectomy or extended cholecystectomy. Remaining 46 patients were treated with palliative treatments. The longest survival time of the resected patients was 3 1/2 years. Mean survival time of patients with palliative treatments was 5.6 months in external biliary drainage and 2.2 months in internal drainage. Thirteen of 76 patients with bile duct cancer were treated with bile duct resection or pancreatoduodenectomy. Remaining 63 patients were treated palliatively. Resectability rate was 10% in upper bile duct, 33% in middle and 36% in lower bile duct. The longest survival time was 3 1/2 years in upper bile duct, 2 2/3 years in middle and 3 5/6 in lower bile duct. Mean survival time of palliative treatments was 5.4 months in external drainage and 8.4 months in internal drainage. Twenty two of 32 patients with cancer of the papilla of Vater were treated with pancreatoduodenectomy. Remaining 10 patients received palliative treatments. The longest survival time was 11 years and 5 year survival rate was 14%. The longest survival time of the palliative treatments was 3 3/4 years and mean survival time was 14.2 months. To improve the resectability and operative results, early diagnosis and extended radical resection are necessary.