Surgical treatment of proximal bile duct tumors.

A new classification of proximal bile duct tumors mainly based on endo- and exobiliary neoplastic invasion, indicating radical or palliative surgery is proposed. Fifty-eight patients underwent radical (12) or palliative (46) surgery. The 5-year survival rate of patients treated radically is 40% compared to 0% in patients treated palliatively; all the patients of this latter group died within 22 months. The authors stress the need for a standard anatomical classification for proximal bile duct tumors.