[The surgical and alternative treatment potentials in biliary tract cancer. I. Surgical treatment]

Biliary apparatus cancer is a rare condition characterized by low operability percentage. This is a comparative study of two series of patients, operated during the periods 1952-1979 and 1980-1994. In the first observation period (28 years) 119 patients are operated, and in the second 13-year period a total of 206 patients are subjected to operative and endoscopic treatment. One-hundred five patients present gallbladder carcinoma. The age, gender and clinical patterns characterizing the contingent being examined do not show noteworthy changes with time. Over the past few years, a variety of palliative operations are used, with the proportion of cases subjected to radical operation showing no increase. Carcinoma of bile ducts is diagnosed in 98 patients. During the second observation period, the number of women and patients in advanced and senile age augment. The diagnosis is delayed; thanks to puncture biopsy with cytological study, histological verification shows a three-fold increase. The number of radical operations is slightly increased while the percentage of explorative laparotomies is noticeably diminished. Carcinoma of papilla Vateri has optimal outlooks for surgical treatment. In the latter case too the number of women and patients above 60 years of age shows an increase. Radical intervention is resorted to in fourteen out of 33 patients.