title: [Diagnosis and surgical treatment of cancer of the gallbladder and extrahepatic bile ducts].
abstract: Data on 148 cases of cancer of the gallbladder and extrahepatic bile ducts were studied. Jaundice proved the cardinal symptom. No clear-cut clinical picture of the disease was identified. Diagnostic procedure should start with ultrasonography. Cholangiectasia and the enlarged pancreatic head make the case for fiber bronchoscopy and hypotonic duodenography. Cancer-negative patients should further undergo transcutaneous transhepatic cholangiography and, if proving still negative, retrograde cholangiopancreatography. Resection of bile ducts with simultaneous lymphadenectomy is considered radical. The authors suggest a surgical procedure for cancer of the gallbladder which includes resection of the liver, hepatico-choledoctomy and cholecystectomy with formation of cholangio-jejuno-anastomosis using disposable transhepatic drains. Recanalization of bile ducts by transhepatic drain is considered optimal for palliation. Survival depends upon extent of surgery and level of bile duct obstruction.
authors.forename: R A
authors.initials: RA
authors.lastname: Nikhinson
authors.forename: Iu A
authors.initials: IuA
authors.lastname: Dykhno
authors.forename: A I
authors.initials: AI
authors.lastname: KryzhanovskiI
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001650:Bile Duct Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000601:surgery*; D002758:Cholangiography; D002760:Cholangiopancreatography, Endoscopic Retrograde; D002763:Cholecystectomy; D005260:Female; D005706:Gallbladder Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D010166:Palliative Care
vernacular_title: Diagnostika i operativnoe lechenie raka zhelchnogo puzyria i vnepechenochnykh zhelchnykh protokov.