[Primary carcinoma of the extrahepatic bile ducts (author's transl)].

From 1957--1977 193 patients were treated at the surgical clinic of the University of Tübingen for carcinoma of the extrahepatic bile ducts. Gall bladder carcinoma made up 139 cases; 54 were of bile duct carcinoma. The tumors were no longer operable in two-thirds of the patients with extrahepatic bile ducts cancer. The life expectancy rate of five years for patients with gall bladder carcinoma held for 7%. Up to now only one patient with a bile duct malignancy has survived longer than five years. In the last decade essentially no improvement of median life expectancy has occurred despite improved operating techniques. Due to uncharacteristic, misleading upper abdominal symptoms, patients who suffer gall bladder or bile duct cancer are unfortunately accurately diagnosed only after the carcinoma has overcome organ borders or is already metastatic. There is reasonable hope for improved early prognosis of extrahepatic bile duct carcinoma with ERCP (Endoscopic Retrograde Cholangio-Pancreaticography) and computer-tomography. Because the possibility of a relationship between gall bladder stones and/or the chronic inflammation of gall bladder and bile ducts and the development of cancer is not out of the question, widespread prophylactic cholecystectomy and gall passage cleansing should be employed.