A CLINICOPATHOLOGICAL STUDY OF RESECTED CASES OF CARCINOMA OF THE PAPILLA OF VATER OR LOWER BILE DUCT

To clarify the prognostic factors, clinicopathological findings were examined for 35 cases of carcinoma of the papilla of Vater and 16 cases of carcinoma of the lower bile duct resected during the past 21 years. For the long-time survival, panco0.1a, n0, d0 for carcinomas of the papilla of Vater and panc0, n0 for carcinomas of the lower bile duct were important. In the past studies, panc had been the most valuable prognostic factor. In our study, cases with panc(+) had high positive rates of d, ly, v for carcinomas of the papilla of Vater and n, ly, v for carcinomas of the lower bile duct. Extended surgery or combination therapy should be into consideration for advanced carcinomas of the papilla of Vater with panc1b, 2, 3, d(+), or n(+), and of the lower bile duct with panc(+) or d(+). When macroscopic and histological findings were compared for the stage, the most lowest consistent rate was noted in d of carcinomas of the papilla of Vater. As to panc, both carcinomas had the consistent rate of about 60%. Therefore, even if we can judge negative for the invasion into the pancreas, duodenum, and lymph nodes macroscopically, we should take a careful attitude to indicate more limited operation and actively employ intraoperative frozen section diagnosis and so on.