Surgical treatment of peripheral cholangiocarcinoma

A retrospective study was performed on 75 patients with tissue-proven peripheral cholangiocarcinoma of the liver treated between January 1977 and December 1988. There were 50 patients (66.6%) with associated intrahepatic stones and 13 patients (17.3%) with mucobilia. There were 61 patients with an infiltrating-type carcinoma, and 14 patients with a papillary-type carcinoma. Twenty-two patients underwent hepatectomies (29.3%), 35 patients had a choledochotomy and tumour biopsy (40.7%) and 18 underwent laparotomies with only a tumour biopsy (24.0%). The overall operative mortality rate was 5.3% (4/75) with hepatectomy and non-hepatectomy group mortalities of 0% and 7.5%, respectively. The overall long-term survival for peripheral cholangiocarcinoma was: one year, 29.3%; two years, 18.7%; three years, 14.7%; four years, 9.3%; and five years, 8.0%. The mean survival time for the hepatectomy group was 31.8 months (range 2-120 months) with survival rates of: one year, 55.5%; two years, 45.5%; three years, 40.9%; four years, 31.7%; and five years, 26.9%. The patients with hepatolithiasis had a better survival pattern than those without hepatolithiasis, but the difference was not statistically significant. Patients with intrahepatic duct carcinoma, whose tumours were grossly papillary or mucus hypersecreting (mucobilia), or were treated with hepatic resection, had a higher chance of long-term survival