Palliative treatment for bile duct carcinoma.
OBJECTIVE
Extrahepatic bile duct carcinoma remains a very difficult problem for the surgeon. The aim of this study was to evaluate the differences between surgical treatment and endoscopic or transhepatic dilatation and intubation.


METHODS
Clinical data from 62 consecutive patients with carcinoma of the extrahepatic bile ducts, who underwent palliative treatment during the past 25 years in our department, were retrospectively analyzed. Preoperative assessment defined site, stage and resectability of tumors.


RESULTS
Tumors were located in the upper third of the bile duct in 32 cases, in the middle third in 17 cases and in the distal third in 13 cases. Transtumoral dilatation was performed in 36 patients (Group A) and cholangioenteric bypass in the remaining 26 patients (Group B). The overall mortality rate was 12.9%. The average survival rate was 6.5 months in group A and 7.3 months in group B.


CONCLUSIONS
In conclusion we suggest that the cholangioenteric bypass offers a better quality of life than non-operative techniques.
Safioleas
M
M
2nd Department of Propedeutic Surgery, Athens University Medical School, Laiko General Hospital, Athens, Greece.
Mantas
D
D
Kakisis
J
J
Manti
C
C
Kouraklis
G
G
Kostakis
A
A
D000368:Aged; D000714:Anastomosis, Surgical; D001650:Bile Duct Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D001653:Bile Ducts, Intrahepatic / Q000473:pathology; D004106:Dilatation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007440:Intubation; D007582:Jejunostomy; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D012189:Retrospective Studies; D015607:Stents; D015996:Survival Rate