[Surgical and endoscopic management of bile duct cancer].
There is still considerable controversy regarding the value of surgical versus nonsurgical treatment for bile duct cancer. Therapeutic modalities vary from total hepatectomy and liver transplantation to percutaneous or endoscopic stent insertion. The aim of this study was to assess the results of the treatment of 118 patients presented with bile duct cancer in the Department of Surgery, University of Szeged, during the time period 1990-2002.


METHODS
The age, male/female ratio, postoperative morbidity and mortality were analyzed.


RESULTS
The resectability rate was 18% (21/118). The mortality rate was 23.8% (5/21) after radical operations and 7% or 12.5% after the palliative procedures. 67 patients had palliative surgery following unsuccessful or recurrent jaundice after non-surgical palliation. The previously applied palliative methods have been transpapillary stenting, endoscopic pig-tail drainage, percutaneous transhepatic drainage or dilatation.


CONCLUSIONS
Palliative surgery for jaundice caused by extrahepatic bile duct cancer is justified in cases with an unsuccessful attempt for endoscopic stenting or occlusion of endoscopically placed endoprothesis. Bilio-enteric bypass with a Roux-Y jejunal loop is superior than external drainage respecting desicterization, postoperative recovery, mortality, complication rate and quality of life.
Márton
János
J
Sebészeti Klinika, Szegedi Tudományegyetem, Altalános Orvostudományi Kar, Szeged 6720, Hungary. g.marton@freemail.hu
Varga
László
L
Géczi
Tibor
T
Farkas
Gyula
G
Balogh
Adám
A
D000368:Aged; D000713:Anastomosis, Roux-en-Y; D001650:Bile Duct Neoplasms / Q000150:complications / Q000401:mortality / Q000601:surgery*; D001662:Biliary Tract Surgical Procedures / Q000379:methods*; D002760:Cholangiopancreatography, Endoscopic Retrograde; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D012189:Retrospective Studies; D016896:Treatment Outcome