[Carcinoma of the hilar bile duct: a clinical and pathological study]

From 1986 through 1990, 50 patients suffering from hilar bile duct carcinoma underwent exploration with the resection of the tumor in 31 (62%), and hepatic lobectomy in 16 (51.6%). There was no operative mortality. Resection of the recurrent tumor was successfully performed in 5 cases, among them 4 were still alive upon 1-4 year follow-up. The median survival period was 15 months for the resection group and late deaths were frequently caused by local recurrence. Pathological study based on 27 surgically resected specimens and 5 autopsies classified the tumors into 4 types: (1)papillary adenocarcinoma (6 cases), (2)well differentiated adenocarcinoma (21 cases), (3) poorly differentiated carcinoma (3 cases), and (4) carcinoma simplex (2 cases). The authors discussed the biological behaviour of such tumors, and stressed the need of early diagnosis of hilar bile duct carcinoma at its subclinical stage.