title: Surgical approaches to cholangiocarcinoma at confluence of hepatic ducts.
abstract: Analysis of the surgical management of 94 consecutive patients with carcinoma at the confluence of the hepatic ducts showed that 20% of them (or 60% of those thought, after comprehensive pre-operative investigation, to have resectable lesions) underwent tumour resection--6 local resections and 12 liver resections. The 30-day hospital mortality was 11% and mean duration of survival was 17 months (7 patients are still alive, with a mean survival of 22.2 months). The quality of life was also much improved after resection. In patients treated with palliative surgery the hospital mortality was 33% and the mean survival was 8.5 months. The results support the treatment of bile-duct carcinoma at the hilum of the liver by resection and suggest that the use of drainage techniques, whether employed surgically or non-surgically, be reserved until the possibility of treatment by resection has been fully considered.
mesh_terms: D002759:Adenoma, Bile Duct / Q000150:complications / Q000401:mortality / Q000601:surgery*; D000328:Adult; D000368:Aged; D001650:Bile Duct Neoplasms / Q000150:complications / Q000401:mortality / Q000601:surgery*; D002779:Cholestasis / Q000209:etiology; D004322:Drainage / Q000379:methods; D005260:Female; D006500:Hepatic Duct, Common / Q000601:surgery; D006801:Humans; D008297:Male; D008722:Methods; D008875:Middle Aged; D010166:Palliative Care; D011788:Quality of Life