Surgical treatment of adenocarcinoma. Location: junction of the right, left, and common hepatic biliary ducts.

Thirty-eight patients with primary adenocarcinoma arising at the junction of the right, left, and common hepatic biliary ducts were seen at the Mayo Clinic, Rochester, Minn, between 1950 and 1976. Prompt and lasting relief of jaundice and cholangitis occurred in four patients undergoing resection of the tumor combined with left hepatic lobectomy, and their mean survival was 33 months. Relief of symptoms was only temporary in 26 patients treated with drainage of the biliary tree, and their mean survival was only ten months. Eight patients undergoing exploration only had no relief of symptoms, and none survived beyond four months. We conclude that resection of these tumors in selected patients gives good palliation and offers the chance of long-term cure. If resection is not possible, biliary decompression results in satisfactory palliation, whereas exploration only does not.