The Study of Surgical Treatment in Hilar Bile Duct Carcinoma and Cholangiocellular Carcinoma for the Elderly

Kentaro Yamagiwa, Akinobu Kondo, Hisaya Kuroda, Go Ikeda, Toshio Iida

First Department of Surgery, Mie University School of Medicine

Recently, the number of elderly patients, age 70 years or oldelr, with hilar bile duct carcinoma (HBDC) and cholangiocellular carcinoma (CCC) has been increasing in Japan. We investigated treatments for those hepato-biliary malignacies in elderly patients. Eighty-three patient (No of elderly: 23 [27.7%]) with HBDC and 39 patients (No of elderly: 6[15.4%]) with CCC were treated in our department (Sept. 1976-Sept. 1996). In the elderly, cardiovascular, respiratory, renal and reticuloendotherial system functions, and the nutritional ascesment score were worse than those of patients younger than 70 years old at admission. The elderly HBDC patients with good function of important organs were selected for surgery, the opeative and liver resection rates in the elderly (73.9%, 21.7%) were lower than those (85%, 55%) of the younger patients, but the radicality of liver resection for HBDC in the elderly was better than in the younger patients. Operative and liver resection rates for CCC in the elderly were the same as those in the younger patients, because extension of CCC of such high grade as to be of no concern with age. There were no significant differences in rates of operative and hospital deaths, and prognosis/QOL according to radicality of the operation between the elderly and younger patients with either HBDC or CCC. In conclusion, radical hepatectomy could be performed in elderly patients with HBDC and CCC, if the risk is good, to improved the QOL of these patients.

Key words
hepato-biliary malignancy, hepatectomy, elderly patients

Reprint requests
Kentaro Yamagiwa The First Department of Surgery, Mie University School of Medicine
2-174 Edobashi, Tsu, 514 JAPAN

Accepted
June 12, 1996

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