Carcinoma of the proximal bile ducts.
The records of 31 patients with carcinoma of the proximal bile ducts were reviewed and the operative procedures, results, causes of deaths and autopsy findings were analyzed and correlated. Ten poor risk patients were treated by external drainage and died of jaundice or abscesses of the liver within six months. However, one patient survived 13 months after effective bilateral drainage. Twelve patients underwent intubation through the tumor into the hepatic ducts with or without postoperative irradiation. Four patients with irradiation survived 42, 15, 15 and ten months, while eight patients without irradiation died within six months. Autopsy findings of two patients who survived 15 months revealed metastases to the various organs. Four patients underwent resection. A patient who underwent resection of the common hepatic duct and hepaticoduodenostomy died of ascending cholangitis nine months postoperatively, while a patient treated by resection of the common hepatic duct with hepaticojejunostomy died of a recurrence 25 months postoperatively. Two patients underwent left hepatic lobectomy and resection of the right hepatic duct followed by hepatojejunostomy. One patient survived 25 months and died of a reccurrence, while the other patient died of abscesses of the liver ten months postoperatively.