[Major hepatic resections for carcinoma of the biliary tract]

The Authors report their experience regarding two primitive tumours of the confluent and one tumour of the gall bladder involving the biliary confluent, all treated by major hepatic demolitions--one left hemihepatectomy and two extended right hemihepatectomies--with removal of the biliary tree en bloc and appropriate reconstruction. These highly demolitionary operations were performed with the aim of achieving greater radicality. The indications for such type of operation, dictated by notions of tumoral biology and reasons of surgical technique, are discussed. The Authors make a comparison of their experience with the data obtained from literature, which up to now reports only twenty-two; no statistical judgment on the effectiveness of the method is therefore possible, even if the results obtained and the theoretical presuppositions would seem to confirm its validity.