Carcinoma of the middle bile duct: is bile duct segmental resection appropriate?
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.
Lee
Hyung-Geun
HG
Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710, South Korea.
Lee
Sang-Hoon
SH
Yoo
Dong-Do
DD
Paik
Kwang-Yeol
KY
Heo
Jin-Seok
JS
Choi
Seong-Ho
SH
Choi
Dong-Wook
DW
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