[Surgical treatment of cancer of the biliary tract and gall bladder].

With the advances in various kinds of diagnostic methods and improvement of operative technique, operations for cancer in biliary tract have recently increased, however, the prognosis has been unsatisfied. During the past 25 years, 495 cases with carcinoma of biliary tract (ca of gall bladder 175 cases, ca of bile duct 201, and ca of papilla vater 105) were operated. The resectability rate was 66% (62% in gall bladder, 62% in bile duct, 84% in papilla vater). Among the lesions in bile duct, the resectable rate in lower bile duct was better than the other site in bile duct. The late results in ca of bile duct, especially in the lesion of upper bile duct were still poor, however, the 5-years survival rate in ca of gallbladder or papilla vater carcinoma was 61% or 56%, respectively. For the further improvement of the surgical results, the sufficient resection of the intrahepatic bile duct in ca of bile duct should be performed, and in gall bladder carcinoma when tumor extends into the neck of gall bladder, bile duct should be resected. In advanced carcinoma, the appropriate hepatectomy or bile duct resection should be considered in proportion to the operative influence and the extension of the tumor.