Between January 1968 and January 1988, we treated 51 patients with carcinoma in the upper third of the biliary tract. 38 of these patients had tumor resection, which was successful in 23 cases (60.5%). The remaining patients received some form of palliative therapy. The 30-day mortality rate following resection was 8.7%, while the mortality rate after palliative surgery was 25%. Mean survival following resection was 26 months, while the mean survival of patients after palliative treatment was only 7.6 months. We concluded that carcinoma in the upper third of the biliary tract should always by explored in order to plan surgical resection.