title: Status of surgical treatment of biliary tract cancer.
abstract: Complete surgical resection of biliary tract carcinoma remains the best treatment. The Japanese Society of Biliary Surgery has organized a registry project and established a classification of biliary tract carcinoma. We report here the status of biliary surgery in Japan. For hilar bile duct carcinoma, major hepatectomy is needed to increase the resection rate, and total caudate lobectomy is required for curative resection. The 5-year survival rate was 39.1%. Middle and distal bile duct carcinomas were treated with pancreatoduodenectomy (PD) or pylorus-preserving PD (PPPD) or bile duct resection alone. The 5-year survival rate was 44.0%. The treatment of gallbladder carcinoma with pT1 lesions is cholecystectomy. The treatment of pT2 lesions is extended cholecystectomy or various hepatectomy with or without extrahepatic bile duct resection along with lymphadenectomy. Treatment of pT3 and pT4 lesions includes hepatectomy with or without bile duct resection, combined with vascular resection, extended lymphadenectomy, and autonomic nerve dissection. Several groups in Japan have performed hepatopancreatoduodenectomy. The 5-year survival rate of pT1, pT2, pT3, and pT4 were 93.7, 65.1, 27.3, and 13.8%. PD or PPPD is the standard operation for carcinoma of the papilla of Vater. The 5-year survival rate was 57.5%.
authors: Department of Biliary Pancreatic Surgery, Fujita Health University, Toyoake, Japan. ishin@fujita-hu.ac.jp
authors: Shin
authors: S
authors: Ishihara
authors: Shuichi
authors: S
authors: Miyakawa
authors: Tadahiro
authors: T
authors: Takada
authors: Ken
authors: K
authors: Takasaki
authors: Yuji
authors: Y
authors: Nimura
authors: Masao
authors: M
authors: Tanaka
authors: Masaru
authors: M
authors: Miyazaki
authors: Takukazu
authors: T
authors: Nagakawa
authors: Masato
authors: M
authors: Kayahara
authors: Akihiko
authors: A
authors: Horiguchi
mesh_terms: D014670:Ampulla of Vater; D001650:Bile Duct Neoplasms / Q000601:surgery; D001661:Biliary Tract Neoplasms / Q000601:surgery*; D005706:Gallbladder Neoplasms / Q000601:surgery; D006801:Humans; D007564:Japan