The Evaluation Of Surgical Approach For Biliary Duct Carcinomas: 10 Years Clinical Data Analysis

Objective :To further document the value of surgical approach for biliary duct carcinomas . Methods :The clinical data of 260 patients with biliary duct carcinoma(included gallbladder carcinoma 125 cases and extrahepatic duct carcinoma 135 cases , which were admitted to our hospital from January 1992 to June 2003) were retrospectively analyzed. The follow-up duration was from d1 to d3770 post-operation, and the average was 687 days . 97. 69% cases were accomplished the follow-up although 2.31% cases were lost. Results1. The radios of the biliary duct carcinomas / biliary duct diseases , gallbladder carcinoma / biliary diseases, gallbladder carcinoma / gallbladder stones were 3. 49%, 1.58%, 1. 96%, respectively in our center .2. The total resection rates and radical resection rates were 84. 16%(85/101) ,42. 57%(43/101)and 70. 75%(75/106), 56. 60%(60/106) in gallbladder carcinoma and extrahepatic duct carcinoma, respectively.3. The overall 1, 3, 5-year survival rates were 35. 58%, 18. 02%, 10. 96% and 46.93%, 37.33%, 18. 75% in gallbladder carcinoma patients and extrahepatic duct carcinoma patients, respectively.4. In radical resection group, 1, 3, 5-year survival rates were 74.76%, 36.60%, 28.82% and 74.94%, 55.74%, 41.27% in gallbladder carcinoma patients and extrahepatic duct carcinoma patients, respectively, and these results were better than that of palliative resection groups( 24.51%, 4.90%, 2.45% and 42.86%, 26.79%, 26.79% respectively) statistically (P < 0. 05) . The survival rates of patients with palliative resection were remarkably higher than that of patients with palliative drainage or without operation: 1,3,5-year survival rates were 42. 86%, 26. 79%, 26. 79% VS23. 33%, 6. 67%, 0 or 17. 86%, 0, 0 (P<0.05) for extrahepatic duct carcinoma . For gallbladder carcinoma, the patients with palliative resection also survived longer than that of without operation : 1,3,5-year survival rates were24. 51%, 4. 90%, 2. 45% VS 4. 17%, 0, 0 (P < 0. 05) , but they were no significant differences between palliative resection and palliative drainage: 1,3,5-year survival rates were 24. 51%, 4. 90%, 2. 45% VS 12. 50%, 0, 0 ( P > 0. 05 ) . Both For gallbladder carcinoma and extrahepatic duct carcinoma , the survival rates were no significant differences between palliative drainage and without operation (P>0. 05) .5. Multivariate analysis revealed that the histopathological grades , TNM stages and modalities were key factors on the outcome . Conclusions :The outcome of the patients with biliary carcinoma is still not optimistic . Radical resection is the first choice for tumors treatment.