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Experience With Radical Resection in The Management of Proximal Bile Duct Cancer

Multiple surgical and nonsurgical approaches have been advocated for the treatment of proximal bile duct cancer. However, survival appears longest when a resection can be performed. Fifteen patients treated at a university center were managed with an aggressive surgical approach. Resection of the tu...

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Autores principales: Emond, Jean C., Mayes, James T., Rouch, Dale A., Thistlethwaite, J. Richard, Broelsch, Christoph E.
Formato: Texto
Lenguaje:English
Publicado: Hindawi Publishing Corporation 1989
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2423541/
https://www.ncbi.nlm.nih.gov/pubmed/2487069
http://dx.doi.org/10.1155/1989/37642
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author Emond, Jean C.
Mayes, James T.
Rouch, Dale A.
Thistlethwaite, J. Richard
Broelsch, Christoph E.
author_facet Emond, Jean C.
Mayes, James T.
Rouch, Dale A.
Thistlethwaite, J. Richard
Broelsch, Christoph E.
author_sort Emond, Jean C.
collection PubMed
description Multiple surgical and nonsurgical approaches have been advocated for the treatment of proximal bile duct cancer. However, survival appears longest when a resection can be performed. Fifteen patients treated at a university center were managed with an aggressive surgical approach. Resection of the tumor was performed in 13 of 15 patients (87%). Of the patients undergoing resection, major hepatic resection was performed in 8 (62%), while excision of vessels with reconstruction was performed in 5 (38%). Eleven of the 13 resected patients (85%) were discharged from the hospital. Clinical symptoms of recurrent disease occurred between 3 and 36 months after surgery in 7 patients, 6 of whom have died. Three other patients are alive at 5, 21, and 36 months without clinical evidence of recurrence. There was no correlation between the completeness of resection and the duration of disease-free survival. These results demonstrate that radical resection of high bile duct tumors can be accomplished with an acceptable early mortality rate, thereby extending the benefits of resection to a higher proportion of patients. While resection is clearly effective at controlling local disease and providing palliation of jaundice, surgical cure remains exceptional. Further improvement in the therapy of bile duct cancer must await development of more effective multi-modality approaches.
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spelling pubmed-24235412008-07-08 Experience With Radical Resection in The Management of Proximal Bile Duct Cancer Emond, Jean C. Mayes, James T. Rouch, Dale A. Thistlethwaite, J. Richard Broelsch, Christoph E. HPB Surg Research Article Multiple surgical and nonsurgical approaches have been advocated for the treatment of proximal bile duct cancer. However, survival appears longest when a resection can be performed. Fifteen patients treated at a university center were managed with an aggressive surgical approach. Resection of the tumor was performed in 13 of 15 patients (87%). Of the patients undergoing resection, major hepatic resection was performed in 8 (62%), while excision of vessels with reconstruction was performed in 5 (38%). Eleven of the 13 resected patients (85%) were discharged from the hospital. Clinical symptoms of recurrent disease occurred between 3 and 36 months after surgery in 7 patients, 6 of whom have died. Three other patients are alive at 5, 21, and 36 months without clinical evidence of recurrence. There was no correlation between the completeness of resection and the duration of disease-free survival. These results demonstrate that radical resection of high bile duct tumors can be accomplished with an acceptable early mortality rate, thereby extending the benefits of resection to a higher proportion of patients. While resection is clearly effective at controlling local disease and providing palliation of jaundice, surgical cure remains exceptional. Further improvement in the therapy of bile duct cancer must await development of more effective multi-modality approaches. Hindawi Publishing Corporation 1989 /pmc/articles/PMC2423541/ /pubmed/2487069 http://dx.doi.org/10.1155/1989/37642 Text en Copyright © 1989 Hindawi Publishing Corporation. http://creativecommons.org/licenses/by/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Emond, Jean C.
Mayes, James T.
Rouch, Dale A.
Thistlethwaite, J. Richard
Broelsch, Christoph E.
Experience With Radical Resection in The Management of Proximal Bile Duct Cancer
title Experience With Radical Resection in The Management of Proximal Bile Duct Cancer
title_full Experience With Radical Resection in The Management of Proximal Bile Duct Cancer
title_fullStr Experience With Radical Resection in The Management of Proximal Bile Duct Cancer
title_full_unstemmed Experience With Radical Resection in The Management of Proximal Bile Duct Cancer
title_short Experience With Radical Resection in The Management of Proximal Bile Duct Cancer
title_sort experience with radical resection in the management of proximal bile duct cancer
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2423541/
https://www.ncbi.nlm.nih.gov/pubmed/2487069
http://dx.doi.org/10.1155/1989/37642
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