ADENOCARCINOMA OF THE EXTRAHEPATIC BILIARY TREE

  • 1 January 1985
    • journal article
    • research article
    • Vol. 67  (3) , 139-143
Abstract
Increasing survival rates for carcinoma of the biliary tree could reflect the selection of patients for referral to a specialist center and modern improvements in diagnosis and treatment. To determine the true incidence and outcome of biliary cancer, the records of 243 unselected Bristol [England, UK] patients were reviewed retrospectively over 15 yr. Mean age was 64 yr. Gallstones were associated in 38% of cases; 69 of 87 patients with gallbladder carcinoma were submitted to laparotomy. The operative (30-day) mortality rate was 56% and the 1 yr survival rate was 7%; 1 patient with an unexpected carcinoma is alive 7 yr after cholecystectomy (1% 5 yr survival rate). Among 31 patients with carcinoma of the ampulla the operative mortality rate was 27%; 1 yr and 5 yr survival rates were 46% and 15%. Bile duct cancers (n = 125) arose proximal to the entry of the cystic duct (n = 63), distal to that point (n = 46) or diffusely (n = 16). For proximal cholangiocarcinoma the operative mortality rate was 38% and 1 yr survival rate 17%; no patient lived for 2 yr. For distal cholangiocarcinoma the operative mortality rate was 45% and 1 yr survival rate 26%; no patient lived for 3 yr. Only pallative procedures were undertaken for diffuse cholangiocarcinoma; 2 patients survived 1 yr (13%). Overall 5 patients with carcinoma of the extrahepatic biliary tree appear to have been cured (2%).