title: Diagnostic and surgical therapeutic features of extrahepatic bile duct carcinoma without jaundice.
abstract: OBJECTIVE
  To analyze the diagnostic and therapeutic features of extrahepatic bile duct carcinoma (EBDC) without jaundice.
  
  
  METHODS
  Between 1985 and 1999, 101 patients underwent surgery for EBDC in Xiangya Hospital. These patients were divided into two groups: 84 jaundiced patients and 17 non-jaundiced patients according to preoperative serum total bilirubin levels. The clinical manifestations, laboratory findings, location, pathology and surgical resectability of the tumors were compared between the two groups.
  
  
  RESULTS
  The laboratory parameters such as hemoglobin, serum albumin ALB, AKP, gamma-GT, and sonography appearance were similar between the two groups, and there was no significant difference in tumor location, pathological type and resectability. However, the number of non-jaundiced patients associated with chololithiasis was significantly greater than that of jaundiced patients (P = 0.008).
  
  
  CONCLUSIONS
  The presence of jaundice is not a reliable criterion for the prediction of the resectability and the extent of tumor progression in extrahepatic bile duct carcinoma. Decreased levels of blood hemoglobin and serum albumin, elevated levels of AKP and gamma-GT, and /or abnormal sonography may be suggestive. Biopsy of a stenotic or thickened bile duct is strongly recommended for a correct diagnosis before the appearance of jaundice.
authors.affiliation: Department of Surgery, Xiangya Hospital of Central South University, Changsha 410008, Hunan Province, China.
authors.forename: Hui-Huan
authors.initials: HH
authors.lastname: Tang
authors.forename: Shi
authors.initials: S
authors.lastname: Chang
authors.forename: Xian-Wei
authors.initials: XW
authors.lastname: Wang
authors.forename: Yun
authors.initials: Y
authors.lastname: Huang
authors.forename: Xue-Jun
authors.initials: XJ
authors.lastname: Gong
authors.forename: Jun
authors.initials: J
authors.lastname: Zhou
mesh_terms: D000328:Adult; D000368:Aged; D001650:Bile Duct Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D017734:Bile Ducts, Extrahepatic / Q000601:surgery; D001663:Bilirubin / Q000097:blood; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007565:Jaundice / Q000209:etiology; D008297:Male; D008875:Middle Aged
chemical_list: D001663:Bilirubin