Surgical treatment for XXXX at the confluence of the major hepatic ducts.

@entity1 @entity5 @entity189
During the period of November 1976 through October 1984, we have treated 46 @entity1 with @entity189 at the confluence of the major hepatic ducts. Curative resection of the @entity5 (where no @entity189 cells at the margin of the resected portion were found macroscopically and microscopially), was performed upon ten @entity1 , palliative resections were done in 11, palliative resection and intraoperative radiotherapy (IOR) in ten, bile duct drainage and IOR in three, and percutaneous transhepatic cholangiodrainage in 12. Among the ten @entity1 who underwent curative operation, five are living six to 104 months after operation while the remaining five died four to 72 months postoperatively. Of the 11 @entity1 who underwent palliative resection, five are alive two to 22 months after operation and six died between four and 20 months after operation. For the ten @entity1 with @entity189 in the advanced stages, palliative resection with IOR was performed. Eight @entity1 died 20 days to 16 months after operation while two @entity1 are alive 13 and 14 months after the procedure. Of the three @entity1 who underwent drainage of the bile duct and IOR, two died three months after operation and one @entity1 survived 34 months. Twelve @entity1 underwent drainage of the bile duct only and all died after 13 months. To perform a curative operation for @entity189 located at the confluence of major hepatic ducts, it is necessary to resect the right or left lobe, including the caudate lobe, in many instances. For the @entity1 with @entity189 in the advanced stages, the possibility of long term survival period after operation exists through the use of the combined techniques of IOR and palliative resection of the @entity5 .
