Clinicopathological Studies of the Resected Intrahepatic Bile Duct Carcinoma

Tohru Fujita

Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical College

Twenty seven cases of resected intrahepatic bile duct carcinoma experienced in our hospital were topographically divided into two types: 1. The central type, those in which the carcinoma was related to the major intrahepatic bile duct (13 cases); 2. The peripheral type (14). Twenty five cases were macroscopically divided into two categories: 1. The ductal type (11 cases); 2. The massive type (14). Their clinical features and modes of spread are presented here. In all 27 cases, hepatic resection was performed. There was only one operative death. Therefore, the survival rate was 96.3%. Regardless of the carcinoma location, lymph node metastasis was seen in 60% of the cases. Lymphatic and blood vessel invasion and perineural invasion were seen in more than 70% of the cases. Seventy-four persent were in stages III and IV. The hilus was dissected in 62% of the patients with central type. The percent age of curative operations was only 26%. ln many cases, the factor which caused to absolute non-curative operations was tw (+). that is, carcinoma cells could be seen at the surgical margin of the liver. Prognosis has a close connection with jaundice, tumor size, lymph node metastasis and curability. Among 6 patients who received relatively non-curative operations, two lived more than 3 years while one lived 4 years and 8 months. As to recurrence, there was a high degree (71%) of peritoneal dissamination. In conclusion, even in advanced cases, every effort to perform a relatively non-curative operation should be made.

Key words
intrahepatic bile duct carcinoma, resected cases of intrahepatic bile duct carcinoma, clinical features of intrahepatic bile duct carcinoma, modes of spread of intrahepatic bile duct carcinoma, central type & peripheral type of intrahepatic bile duct carcinoma

Reprint requests
Tohru Fujita The Institute of Gastroenterology, Tokyo Women's Medical College
8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162 JAPAN

Accepted
October 11, 1989

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