[Supra-ampullary neoplasms of the biliary tract. Analysis of 16 cases]

A series of sixteen patients with supra-ampullary tumours of the biliary tree is reviewed. There was no sex difference and 9 from 16 were more than 60 years old. The clinical picture was insidious in 10 patients with dyspeptic symptoms; and started suddenly in 6; jaundice was the first symptom in 3, and was always present at admission. The delay for a correct diagnosis was 5 months since the beginning of the symptoms, and it was obtained by direct visualization of the biliary tree (PTC or/and ERCP). Surgical removal of the tumour was possible only in 3 patients. Microscopic diagnosis was obtained in 12 patients: 11 carcinomas (6 non-differentiated) and 1 lymphoma. Local metastasis were found only in 5 cases, with a mean evolution longer than 6 months. Until now, surgery has been disappointing; a more aggressive diagnostic approach conducting to earlier surgical treatment can probably improve the results.