title: Carcinoma of the middle bile duct: is bile duct segmental resection appropriate?
abstract: OBJECTIVE
  To compare survival between bile duct segmental resection (BDSR) and pancreaticoduodenectomy (PD) for treating distal bile duct cancers.
  
  
  METHODS
  Retrospective analysis was conducted for 45 patients in a BDSR group and for 149 patients in a PD group.
  
  
  RESULTS
  The T-stage (P < 0.001), lymph node invasion (P = 0.010) and tumor differentiation (P = 0.005) were significant prognostic factors in the BDSR group. The 3- and 5-year overall survival rates for the BDSR group and PD group were 51.7% and 36.6%, respectively and 46.0% and 38.1%, respectively (P = 0.099). The BDSR group and PD group did not show any significant difference in survival when this was adjusted for the TNM stage. The 3- and 5-year survival rates were: stage Ia [BDSR (100.0% and 100.0%) vs PD (76.9% and 68.4%) (P = 0.226)]; stage Ib [BDSR (55.8% and 32.6%) vs PD (59.3% and 59.3%) (P = 0.942)]; stage IIb [BDSR (19.2% and 19.2%) vs PD (31.9% and 14.2%) (P = 0.669)].
  
  
  CONCLUSIONS
  BDSR can be justified as an alternative radical operation for patients with middle bile duct in selected patients with no adjacent organ invasion and resection margin is negative.
authors.affiliation: Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710, South Korea.
authors.forename: Hyung-Geun
authors.initials: HG
authors.lastname: Lee
authors.forename: Sang-Hoon
authors.initials: SH
authors.lastname: Lee
authors.forename: Dong-Do
authors.initials: DD
authors.lastname: Yoo
authors.forename: Kwang-Yeol
authors.initials: KY
authors.lastname: Paik
authors.forename: Jin-Seok
authors.initials: JS
authors.lastname: Heo
authors.forename: Seong-Ho
authors.initials: SH
authors.lastname: Choi
authors.forename: Dong-Wook
authors.initials: DW
authors.lastname: Choi
mesh_terms: D000328:Adult; D000368:Aged; D001650:Bile Duct Neoplasms / Q000473:pathology / Q000601:surgery*; D001652:Bile Ducts / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis / Q000473:pathology; D008297:Male; D008875:Middle Aged; D016577:Pancreaticoduodenectomy; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome