Clinicopathological study of carcinoma of the bifurcation of hepatic duct.

Ten cases of carcinoma of the bifurcation of hepatic duct were studied, 9 were resected and one case was autopsied. They were classified into two types according to the type of infiltration: Type 1 included cases, in which cancer cells were demonstrated in the mucosal or submucosal layer at a distance greater than 11 mm from the main tumors. Type 2 included the cases less than 11 mm distant. Histologic type and gross configuration had no correlation with the type of infiltration. Concerning hepatic infiltration, vascular invasion, serosal invasion and perineural invasion, Type 1 was more extensive than Type 2. Three Type 2 cases were all curatively resected, while all except one Type 1 were noncuratively resected. Three cases where the tips of the bile duct appeared to form a V and were connected through a narrow, long, stenotic bile duct on the preoperative cholangiographic figure were all Type 1. In these cases, cancer cells were thought to infiltrate into bilateral hepatic lobes, and as cancer cells would remain if only lobectomy is done, trisegmentectomy should be performed.