Management of carcinoma of the extrahepatic bile ducts

The records of 80 cases of carcinoma of the extrahepatic bile ducts were studied. The median duration of survival, in months, of patients who were treated by curative surgery, palliative surgery and radiation, palliative surgery alone and biopsy alone was 21.7, 9.3, 5.5 and 1, respectively. The best results were obtained by excision of the tumour, but only 10% of tumours were considered resectable. A more aggressive surgical approach to tumours still confined to the bile ducts might be expected to increase the resectability rate and improve survival. The use of a U tube is recommended because it ensures greater comfort even though survival is no longer than when a T tube is used. The roles of adjuvant radiotherapy and chemotherapy need further study. Because of some encouraging responses with the use of radiotherapy and the infusion of 5-fluorouracil the authors are currently evaluating these two methods of treatment.