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Extended right hepatic lobectomy left hepatic lobectomy and skeletonization resection for proximal bile duct cancer

, : Extended right hepatic lobectomy left hepatic lobectomy and skeletonization resection for proximal bile duct cancer. World Journal of Surgery 12(1): 52-59

Tumors in the proximal third of the bile duct are associated with the lowest rates of resectability and poorest survival of tumors in all locations in the duct. Of 25 patients who underwent resection for tumors located proximally, 3 had extended right hepatic lobectomy, 6 had left hepatic lobectomy, and 16 had skeletonization resection. The operative mortality rate was 4% overall and 0 for patients undergoing hepatic resection. Actuarial survival at 1, 3, and 5 years was 84%, 44%, and 35%, respectively, with almost all patients dying with disease. Survival was longer for patients who had curative resection than for those who had palliative resection. Survival was longer after hepatic lobectomy than after skeletonization resection but was not statistically significant. Survival for the 25 patients who underwent resection compared favorably with the survival of 131 patients treated by strictly palliative procedures, and the quality of life for patients with resection was also improved. We conclude that aggressive resection for cure is the procedure of choice in selected patients with proximal bile duct cancer, but that it must be performed with low operative mortality. Current patient selection and operative techniques are described.

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Accession: 005432668

PMID: 2449770

DOI: 10.1007/bf01658486

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