[The surgical treatment of carcinoma of the extrahepatic bile ducts].
The authors have carried out a retrospective analysis of 157 patients with Ca in the extrahepatic biliary system, treated at the Clinic for Hepato-Biliary and Pancreatic Surgery within the period 1982-1992. From them 68 patients (43.31%) were with Ca in vesicule biliary and with Ca in the biliary tracts--89 patients (56.69%). The ratio men:women was respectively 1:4.67 and 1.12:1. The medium age of the patients was 63.08 years. In the group of the patients with Ca in biliary tracts the carcinoma was located in the upper third in 20.22% of the cases, in the middle third--in 24.72%, in the distal third--in 55.06%. Radical operations were made in 31.46% of the patients, with lethality 28.57%, whereas the postoperative lethality of the patients with duodeno-hemipancreatectomy was 6.67%, and the average postoperative survival was 32 months. The palliative operated patients constituted 65.17% in the general series, with lethality 15.52% and average postoperative survival 10.4 months. The explorative laparatomies constitute 3.37% from the operated patients. The total operative lethality was 19.1%. In the article the authors discussed the diagnostical methods, stated the preference for echography, computer axial tomography and retrograde cholangio-pancreatography in the mentioned sequence. The endoscopic procedures were discussed as and alternative for the non-resectable carcinomas of the biliary tracts.