Outcome of treatment for distal bile duct cancer

All patients with distal bile duct tumours over a 10‐year period (October 1983 to December 1993) were identified by means of a prospective database. The medical records of 104 patients were reviewed. Univariate and multivariate analysis for predictors of outcome was performed. Median age of the pati...

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Bibliographic Details
Published in:British journal of surgery 1996-12, Vol.83 (12), p.1712-1715
Main Authors: Fong, Y., Blumgart, L. H., Lin, E., Fortner, J. G., Brennan, M. F.
Format: Article
Language:English
Subjects:
Adenocarcinoma - surgery
Adult
Aged
Aged, 80 and over
Bile Duct Neoplasms - surgery
Biological and medical sciences
Cholestasis - etiology
Female
Gastroenterology. Liver. Pancreas. Abdomen
Humans
Length of Stay
Liver. Biliary tract. Portal circulation. Exocrine pancreas
Lymphatic Metastasis
Male
Medical sciences
Middle Aged
Prospective Studies
Survival Rate
Tumors
Weight Loss
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Summary:All patients with distal bile duct tumours over a 10‐year period (October 1983 to December 1993) were identified by means of a prospective database. The medical records of 104 patients were reviewed. Univariate and multivariate analysis for predictors of outcome was performed. Median age of the patients was 65 (range 30–89) years. Patients presented with a clinical picture indistinguishable from that of pancreatic ductal adenocarcinoma. Twenty patients had no surgical treatment and 23 had a diagnostic laparotomy only. Biliary bypass was performed in 16 patients and radical resection was performed in 45 (pancreaticoduodenectomy, 39; bile duct excision, six). Operative mortality occurred in two of 45 patients having radical resection and complications in 17. Resection provided significant survival benefit. By univariate and multivariate analysis, resectability and negative node status (P < 0‐001) were the only predictors of favourable outcome. Sex, age, preoperative stenting, grade of tumour and bilirubin level did not predict outcome. The 5‐year survival rate for radically resected, node‐negative tumours was 54 per cent. Surgical resection is effective therapy for distal bile duct tumours. These patients have a better outlook than those having resection of pancreatic adenocarcinoma.
ISSN:0007-1323
1365-2168
DOI:10.1002/bjs.1800831217