Radical surgery for middle and distal thirds bile duct cancer

A total of 38 patients with middle and distal thirds bile duct cancer treated in our department during a period of 20 years were reviewed and analyzed in respect to the type of operative procedures employed and the long‐term results. The purpose of the study was to evaluate the impact of various recently available modalities for diagnosis and treatment on the prognosis of patients with these malignancies. The longest mean survival was 22.8 months after resection and the shortest was 3.5 months after intubation. Resectability increased during the course of the study, especially for distal bile duct cancer, and reached 70% in the last 10 years. Either local excision of the bile duct or pancreatoduodenectomy was chosen as a radical operative procedure for middle bile duct cancer, however, curative resection was obtained only by the latter. Pancreatoduodenectomy was the only choice of radical treatment for distal thirds bile duct cancer. Postoperative morbidity decreased during the last 10 years and preoperative biliary decompression significantly improved the postoperative survival time.