Abstract
This study was made on 20 operated cases (48.1 per cent) out of 41 cases of bile duct cancer at the hepatic hilar region at the department in the past 22 years. In this series (11 resected and 9 unresected) an absolute curative resection was achieved in 2 cases, a relative curative resection was achieved in 3 cases and 6 cases were non-curative resections. The main reason for non-curative resections was cancer infiltration. Most of the patients with non-curative resection died within 1 year, but one-year and two-year survival rates in resected cases were 81.8 per cent and 45.5 per cent respectively. Among Stage IV cases, the survival rate of resected cases was significantly higher than that of non-resected cases. In resected cases, most of the patients with tumor infiltration of the surgical margin died within 2 years, but the two-year survival rate of patients with tumor-free surgical margins was 75.0 per cent. A resected Stage IV patient with combined therapy survived for 3 years and 9 months. These results suggest that tumorfree surgical margin is necessary in order to improve the outcome of bile duct cancer at the hepatic hilar region and combined therapy may improve the outcome.
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