Treatment of carcinoma of the biliary system.

A series of 23 patients with carcinoma at the hilus of the bile duct were studied. Fourteen of the 23 patients underwent surgical resection. Nine of the 14 patients had a curative resection. Six patients are alive after a follow-up period of five to 25 months. The remaining five patients had noncurative resection, and four of them died from metastatic carcinomas during the next 14 months. One patient who had a left hepatic lobectomy is still alive eight months after operation. The other three patients with advanced carcinoma at the hilus of the bile duct were treated by intraoperative radiotherapy. A single dose of 3,000 rads was emitted directly to the tumors. The remaining six patients were treated by drainage procedures only. Four patients with advanced carcinoma of the gallbladder had received radiotherapy. Six of the eight patients who were treated by radiotherapy are alive, although the follow-up period extends to 11 months only.