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An examination was done on four patients undergoing resection of bile duct carcinoma, experienced in our hospital over the last five years. Primary tumors in all cases were located in the middle portion of the bile duct and therefore able to be resected by pancre-aticoduodenostomy.Pathological evaluation of tissue removed at the time of surgery revealed neural invasion in all patients, lymphatic metastasis in one patient and remnant of malignant cells on the cut end of the bile duct toward liver in two patients. Lymphatic metastasis was turned out to be a so-called jumping metastasis. Two patients with remnant of malignant cells showed local recurrence at the anastomotic site of the bile duct within one year.From the pathological results mentioned above, it is considered that the bile duct resection should be associated with dissection of purrounding tissue with enough extent, including neural and lymphatic elements. It is also considered that the bile duct should be cut as far as possible from primary tumor in order to prevent remnant of carcinoma cells in the bile duct.In case of recurrence biliary drainage should be considered for prolongation of survival time.
一般社団法人国立医療学会の論文