Malignant tumors of the extrahepatic bile ducts.

A series of 76 patients treated for carcinoma of the extrahepatic bile ducts at three Swedish hospitals during the years 1952 to 1973 was studied. The mean age of the patients was 68 years. Gallstones were found in 22 patients, whereas 11 patients had undergone cholecystectomy earlier for gallstone disease. At operation widespread metastases were found less often in patients with cancer of the papilla of Vater than in patients with cancer of other locations. This is interpreted as indicating that patients with papillary carcinoma are treated in an earlier stagage of the disease. This interpretation is supported by the finding that these patients had a longer length of survival after bypass supported by the finding that these patients had a longer length of survival after bypass supported by the finding that these patients had a longer length of survival after bypass operations (11.5 months). In spite of treatment in an early stage, survival after radical surgery was disappointingly short (4.6 months). On the other hand, patients with cancer located above the papilla of Vater survived for 6.8 months after bypass operations as compared with 23.3 months after rescetion. The possibilities of radical surgery should be considered carefully, especially in patients in whom the malignancy is located above the papillary region.