Abstract
The only curative treatment for proximal bile duct cancer with involvement of both main hepatic ducts is liver transplantation. Most patients do not fulfill the requirements for liver transplantation. Our treatment strategy in appropriate cases is palliative tumor resection and reconstruction of the biliary passage by sutureless bilioenteric anastomosis. We have treated 12 patients, 5 in combination with intraluminal and percutaneous radiotherapy. Our results indicate that this strategy leads to effective palliation in some cases provided that only microscopic residual tumor is left in-situ. Our survival times compare favourably with survival after liver transplantation.
Highlights
INVOLVEMENT OF BOTH MAIN HEPATIC DUCTS WORTHWHILE?Of Surgery, University of Munich, FRG 2Dept
Bile duct cancer is a rare tumor accounting for 7% of all gastrointestinal malignancies[1]
In the past proximal bile duct tumors were classified into three types, according to their extension in relation to the hepatic confluence[3]
Summary
Of Surgery, University of Munich, FRG 2Dept. Of Radiology and Radiotherapy, University of Munich, FRG. The only curative treatment for proximal bile duct cancer with involvement of both main hepatic ducts is liver transplantation. Most patients do not fulfill the requirements for liver transplantation. Our treatment strategy in appropriate cases is palliative tumor resection and reconstruction of the biliary passage by sutureless bilioenteric anastomosis. We have treated 12 patients, 5 in combination with intraluminal and percutaneous radiotherapy. Our results indicate that this strategy leads to effective palliation in some cases provided that only microscopic residual tumor is left in-situ. Our survival times compare favourably with survival after liver transplantation. KEY WORDS" Proximal bile duct cancer, palliation, intrahepatic sutureless bilioenteric anastomosis, intraluminal radiotherapy
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