The Prognostic Factors of Surgical Treatment in Hilar Cholangiocarcinoma——Follow-up Study in 45 Patients

Between Januray, 1986 and December, 1990. Forty-five patients with hilar cholangiocarcinoma were performed operation in our department. Resection of the tumor was carried out in 29 patients. The rate of resection was 64.4％. There were no operative deaths and the survival rates were 41.4％ and 20.7％ at 12 and 24 months in the group of patients underwent tumor resection, but, the 60-day hospital mortality rate was 37.5％ and there was no survivor at 12 months in the group of patients underwent unresective operation The survival rates were significantly different between the patients performed curative resection and the patients with resective cancer margins or palliative resection. The 28％ of patients with curative resection were survival at 18 months but no one of patient with marginal carcinona was survival. Most of patients in the group of resection died from the tumor recurrence or appearance of jaundice again during 6 to 12 months. The results indicated that the remnant cancer of resective margins and tumor recurence were common in the group of patients with local or skeletization resection. There was no siginaficant difference between the type of tumor pathology and the degree of cancer invasion. We concluded that liver resection of hilar cholangiocarcinoma may give long-term survival times if a tumor free resection margin is obtained. The importance of a free resection margin indicates that surgical treatment should be made under the sufficient estimation of the tumor invasion and the extension of liver resection with the good condition of the remaining liver.