Skip to main content
SpringerLink
Log in
SpringerLink
Log in

Malignant Diseases of the Gallbladder and Bile Ducts

  • Chapter
  • First Online:
Principles and Practice of Geriatric Surgery

  • 1638 Accesses

Abstract

Gallbladder and bile duct cancers are relatively uncommon malignancies and tend to occur primarily in elderly patients. Although the overall prognosis of these malignancies remains poor, recent advances in hepatobiliary surgery, perioperative care, and adjuvant therapy have helped to improve overall survival and quality of life. A multidisciplinary approach in the management of these patients, including surgery, medical oncology, radiation oncology, and invasive radiology, is critical to achieving favorable results.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Jones RS (1990) Carcinoma of the gallbladder. Surg Clin North Am 70:1419–1428

    PubMed  CAS  Google Scholar 

  2. Piehler JM, Crichlow RW (1978) Primary carcinoma of the gallbladder. Surg Gynecol Obstet 147:929–939

    PubMed  CAS  Google Scholar 

  3. Carriaga MT, Henson DE (1995) Liver, gallbladder, extrahepatic bile ducts, and pancreas. Cancer 75:171–190

    PubMed  CAS  Google Scholar 

  4. Ransohoff DF, Gracie WA (1993) Treatment of gallstones. Ann Intern Med 119:606–619

    PubMed  CAS  Google Scholar 

  5. Strom BL, Soloway RD, Rios-Dalenz JL et al (1995) Risk factors for gallbladder cancer: an international collaborative case-control study. Cancer 76:1747–1756

    PubMed  CAS  Google Scholar 

  6. Lowenfels AB, Lindstrom CG, Conway MJ et al (1985) Gallstones and risk of gallbladder cancer. J Natl Cancer Inst 75:77–80

    PubMed  CAS  Google Scholar 

  7. De Aretxabala X, Roa I, Burgos L et al (1992) Gallbladder cancer in Chile: a report on 43 potentially resectable tumors. Cancer 69:60–65

    PubMed  Google Scholar 

  8. Nervi F, Duarte I, Gomez G et al (1988) Frequency of gallbladder cancer in Chile: a high-risk area. Int J Cancer 41:657–660

    PubMed  CAS  Google Scholar 

  9. Pitt HA, Dooley WC, Yeo CJ et al (1995) Malignancies of the biliary tree. Curr Probl Surg 32:1–90

    PubMed  CAS  Google Scholar 

  10. Wibbenmeyer LA, Wade TP, Chen RC et al (1995) Laparoscopic cholecystectomy can disseminate in situ carcinoma of the gallbladder. J Am Coll Surg 181:504–510

    PubMed  CAS  Google Scholar 

  11. Liu KJM, Richter HM, Cho MJ et al (1997) Carcinoma involving the gallbladder in elderly patients presenting with acute cholecystitis. Surgery 122:748–756

    PubMed  CAS  Google Scholar 

  12. Zatonski WA, Lowenfels AB, Boyle P et al (1997) Epidemiologic aspects of gallbladder cancer: a case-control study of the SEARCH program of the international agency for research on cancer. J Natl Cancer Inst 89:1132–1138

    PubMed  CAS  Google Scholar 

  13. Fahim RB, McDonald JR, Richards JC et al (1962) Carcinoma of the gallbladder: a study of its modes of spread. Ann Surg 156:114–123

    PubMed  CAS  Google Scholar 

  14. Shirai Y, Yoshida K, Tsukada K et al (1992) Identification of the regional lymphatic system of the gallbladder by vital staining. Br J Surg 79:659–662

    PubMed  CAS  Google Scholar 

  15. Shirai Y, Tsukada K, Ohtani T et al (1995) Hepatic metastases from carcinoma of the gallbladder. Cancer 75:2063–2068

    PubMed  CAS  Google Scholar 

  16. Edge SE, Byrd DR, Carducci MA, Compton CA (eds) (2010) AJCC cancer staging manual, 7th edn. Springer, New York

    Google Scholar 

  17. White K, Kraybill WG, Lopez MJ (1988) Primary carcinoma of the gallbladder: TNM staging and prognosis. J Surg Oncol 39:251–255

    PubMed  CAS  Google Scholar 

  18. Soyer P, Gouhiri M, Boudiaf M et al (1997) Carcinoma of the gallbladder: imaging features with surgical correlation. AJR Am J Roentgenol 169:781–785

    PubMed  CAS  Google Scholar 

  19. Mizuguchi M, Kudo S, Fukahori T et al (1997) Endoscopic ultrasonography for demonstrating loss of multiple-layer pattern of the thickened gallbladder wall in the preoperative diagnosis of gallbladder cancer. Eur Radiol 7:1323–1327

    PubMed  CAS  Google Scholar 

  20. Shirai Y, Yoshida K, Tsukada K et al (1992) Inapparent carcinoma of the gallbladder: an appraisal of a radical second operation after simple cholecystectomy. Ann Surg 215:326–331

    PubMed  CAS  Google Scholar 

  21. Donohue JH, Nagorney DM, Grant CS et al (1990) Carcinoma of the gallbladder: does radical resection improve outcome? Arch Surg 125:237–241

    PubMed  CAS  Google Scholar 

  22. Cubertafond P, Gainant A, Cucchiaro G (1994) Surgical treatment of 724 carcinomas of the gallbladder: results of the French Surgical Association survey. Ann Surg 219:275–280

    PubMed  CAS  Google Scholar 

  23. Tsukada K, Kurosaki I, Uchida K et al (1997) Lymph node spread from carcinoma of the gallbladder. Cancer 80:661–667

    PubMed  CAS  Google Scholar 

  24. Tsukada K, Hatakeyama K, Kurosaki I et al (1996) Outcome of radical surgery for carcinoma of the gallbladder according to the TNM stage. Surgery 120:816–822

    PubMed  CAS  Google Scholar 

  25. Ogura Y, Mizumoto R, Isaji S et al (1991) Radical operations for carcinoma of the gallbladder: present status in Japan. World J Surg 15:337–343

    PubMed  CAS  Google Scholar 

  26. Ouchi K, Suzuki M, Tominaga T et al (1994) Survival after surgery for cancer of the gallbladder. Br J Surg 81:1655–1657

    PubMed  CAS  Google Scholar 

  27. Nakamura S, Nishiyama R, Yokoi Y et al (1994) Hepatopan­creatoduodenectomy for advanced gallbladder carcinoma. Arch Surg 129:625–629

    PubMed  CAS  Google Scholar 

  28. Gall FP, Kockerling F, Scheele J et al (1991) Radical operations for carcinoma of the gallbladder: present status in Germany. World J Surg 15:328–336

    PubMed  CAS  Google Scholar 

  29. Bartlett DL, Fong Y, Fortner JG et al (1996) Long-term results after resection for gallbladder cancer: implications for staging and management. Ann Surg 224:639–646

    PubMed  CAS  Google Scholar 

  30. Bloechle C, Izbicki JR, Passlick B et al (1995) Is radical surgery in locally advanced gallbladder carcinoma justified? Am J Gastroenterol 90:2195–2200

    PubMed  CAS  Google Scholar 

  31. Jones RS (1991) Palliative operative procedures for carcinoma of the gallbladder. World J Surg 15:348–351

    PubMed  CAS  Google Scholar 

  32. Miyazaki M, Itoh H, Ambiru S et al (1996) Radical surgery for advanced gallbladder carcinoma. Br J Surg 83:478–481

    PubMed  CAS  Google Scholar 

  33. Falkson G, MacIntyre JM, Moertel CG (1984) Eastern Cooperative Oncology Group experience with chemotherapy for inoperable gallbladder and bile duct cancer. Cancer 54:965–969

    PubMed  CAS  Google Scholar 

  34. Gebbia V, Majello E, Testa A et al (1996) Treatment of advanced adenocarcinomas of the exocrine pancreas and the gallbladder with 5-fluorouracil, high dose levofolinic acid and oral hydroxyurea on a weekly schedule. Cancer 78:1300–1307

    PubMed  CAS  Google Scholar 

  35. Kraybill WG, Lee H, Picus J et al (1994) Multidisciplinary treatment of biliary tract cancers. J Surg Oncol 55:239–245

    PubMed  CAS  Google Scholar 

  36. Todoroki T, Iwasaki Y, Orii K et al (1991) Resection combined with intraoperative radiation therapy (IORT) for stage IV (TNM) gallbladder carcinoma. World J Surg 15:357–366

    PubMed  CAS  Google Scholar 

  37. Todoroki T (1997) Radiation therapy for primary gallbladder cancer. Hepatogastroenterology 44:1229–1239

    PubMed  CAS  Google Scholar 

  38. Gameron JL, Pitt HA, Zinner MJ et al (1990) Management of proximal cholangiocarcinoma by surgical resection and radiotherapy. Am J Surg 159:91–98

    Google Scholar 

  39. Nakeeb A, Pitt HA, Sohn TA et al (1996) Cholangiocarcinoma: a spectrum of intrahepatic, perihilar, and distal tumors. Ann Surg 224:463–475

    PubMed  CAS  Google Scholar 

  40. Tompkins RK, Saunders K, Roslyn JJ et al (1990) Changing patterns in diagnosis and management of bile duct cancer. Ann Surg 211:614–621

    PubMed  CAS  Google Scholar 

  41. Nagorney DM, Donohue JH, Farnell MB et al (1993) Outcomes after curative resections of cholangiocarcinoma. Arch Surg 128:871–877

    PubMed  CAS  Google Scholar 

  42. Broe PJ, Cameron JL (1981) The management of proximal biliary tract tumors. Adv Surg 15:47–62

    PubMed  CAS  Google Scholar 

  43. Sons HU, Borchard F (1987) Carcinoma of the extrahepatic bile ducts: a postmortem study of 65 cases and review of the literature. J Surg Oncol 34:6–12

    PubMed  CAS  Google Scholar 

  44. Miller BA, Ries LAG, Hankey BF et al (1993) SEER cancer statistics review: 1973–1990 (NIH Publ No. 93-2789). National Cancer Institute, Bethesda

    Google Scholar 

  45. Ahrendt SA, Pitt HA, Kalloo AN et al (1998) Primary sclerosing cholangitis: resect, dilate, or transplant? Ann Surg 227:412–423

    PubMed  CAS  Google Scholar 

  46. Lipsett PA, Pitt HA et al (1994) Choledochal cyst disease: a changing pattern of presentation. Ann Surg 220:644–652

    PubMed  CAS  Google Scholar 

  47. Sheen-Chen SM, Chou FF, Eng HL (1991) Intrahepatic cholangiocarcinoma in hepatolithiasis: a frequently overlooked disease. J Surg Oncol 47:131–135

    PubMed  CAS  Google Scholar 

  48. Fan ST, Lai EC, Wong J (1993) Hepatic resection for hepatolithiasis. Arch Surg 128:1070–1074

    PubMed  CAS  Google Scholar 

  49. Chijiiwa K, Ichimiya H, Kuroki S et al (1993) Late development of cholangiocarcinoma after the treatment of hepatolithiasis: immunohistochemical study of mucin carbohydrates and core proteins in hepatolithiasis and cholangiocarcinoma. Int J Cancer 55:82–91

    Google Scholar 

  50. Bismuth H, Nakache R, Diamond T (1992) Management strategies in resection for hilar cholangiocarcinoma. Ann Surg 215:31–38

    PubMed  CAS  Google Scholar 

  51. Ramage JK, Donaghy A, Farrant JM (1995) Serum tumor markers for the diagnosis of cholangiocarcinoma in primary sclerosing cholangitis. Gastroenterology 108:865–869

    PubMed  CAS  Google Scholar 

  52. Langer JC, Langer B, Taylor BR et al (1985) Carcinoma of the extrahepatic bile ducts: results of an aggressive surgical approach. Surgery 98:752–759

    PubMed  CAS  Google Scholar 

  53. Looser CH, Stain SC, Baer HU et al (1992) Staging of hilar cholangiocarcinoma by ultrasound and duplex sonography: a comparison with angiography and preoperative findings. Br J Radiol 65:871–877

    PubMed  CAS  Google Scholar 

  54. Yamashita Y, Takahashi M, Kanazawa S et al (1992) Parenchymal changes of the liver in cholangiocarcinoma: CT evaluation. Gastrointest Radiol 17:161–166

    PubMed  CAS  Google Scholar 

  55. Hann LE, Graetrex KV, Bach AM et al (1997) Cholangiocarcinoma at the hepatic hilus: sonographic findings. AJR Am J Roentgenol 168:985–989

    PubMed  CAS  Google Scholar 

  56. Saeki M, Pitt HA, Tempany CM (1992) Magnetic resonance imaging of hilar cholangiocarcinoma (abstract). In: Proceedings of the international hepatobiliary pancreatic association, 100A

    Google Scholar 

  57. Lomanto D, Pavone P, Laghi A et al (1997) Magnetic resonance-cholangiopancreatography in the diagnosis of biliopancreatic disease. Am J Surg 174:33–38

    PubMed  CAS  Google Scholar 

  58. Pitt HA, Gomes AS, Lois JF et al (1985) Does preoperative percutaneous biliary drainage reduce operative risk or increase hospital cost? Ann Surg 201:545–553

    PubMed  CAS  Google Scholar 

  59. Nakeeb A, Pitt HA (1995) The role of preoperative biliary decompression in obstructive jaundice. Hepatogastroenterology 42:332–339

    PubMed  CAS  Google Scholar 

  60. Little JM (1987) A prospective evaluation of computerized estimates of risk in the management of obstructive jaundice. Surgery 102:473–476

    PubMed  CAS  Google Scholar 

  61. Cope C, Marinelli DL, Weinstein JK (1988) Transcatheter biopsy of lesions obstructing the bile ducts. Radiology 169:555–560

    PubMed  CAS  Google Scholar 

  62. Desa LA, Akosa AB, Lazzara S et al (1991) Cytodiagnosis in the management of extrahepatic biliary stricture. Gut 32:1188–1191

    PubMed  CAS  Google Scholar 

  63. Ferrucci JT, Chuttani R (1995) Magnetic resonance cholangiopancreatography (MRCP): comparison to invasive cholangiopancreatography. Hepatology 22:107A

    Google Scholar 

  64. Foutch PG, Kerr DM, Horlan JR et al (1990) Endoscopic retrograde wire-guided brush cytology for diagnosis of patients with malignant obstruction of the bile duct. Am J Gastroenterol 85:791–795

    PubMed  CAS  Google Scholar 

  65. Pitt HA, Cameron JL, Postier RG et al (1981) Factors influencing mortality in biliary tract surgery. Am J Surg 141:66–72

    PubMed  CAS  Google Scholar 

  66. Su CH, Tsay SH, Wu CC et al (1996) Factors influencing postoperative morbidity, mortality, and survival after resection for hilar cholangiocarcinoma. Ann Surg 223:384–394

    PubMed  CAS  Google Scholar 

  67. Lynn RB, Wilson JAP, Cho KJ (1988) Cholangiocarcinoma: role of percutaneous transhepatic cholangiography in determination of resectability. Dig Dis Sci 33:587–592

    PubMed  CAS  Google Scholar 

  68. Dooley WC, Pitt HA, Venbrux AD et al (1992) Is angiography useful in patients with perihilar cholangiocarcinoma (abstract). In: Proceedings of the international hepatobiliary pancreatic association, 32A

    Google Scholar 

  69. Dooley WC, Cameron JL, Pitt HA et al (1990) Is preoperative angiography useful in patients with periampullary tumors? Ann Surg 211:649–655

    PubMed  CAS  Google Scholar 

  70. Nordback IH, Pitt HA, Coleman JA et al (1994) Unresectable hilar cholangiocarcinoma: percutaneous versus operative palliation. Surgery 115:597–603

    PubMed  CAS  Google Scholar 

  71. Soto JA, Carish MA, Yucel EK et al (1996) Magnetic resonance cholangiography: comparison with endoscopic retrograde cholangiopancreatography. Gastroenterology 110:589–597

    PubMed  CAS  Google Scholar 

  72. Lee MG, Lee HJ, Kim MH et al (1997) Extrahepatic biliary diseases: 2D MR cholangiography compared with endoscopic retrograde cholangiopancreatography. Radiology 202:663–669

    PubMed  CAS  Google Scholar 

  73. Hausegger KA, Kleinert R, Lammer J et al (1992) Malignant biliary obstruction: histologic findings after treatment with self-expandable stents. Radiology 185:461–464

    PubMed  CAS  Google Scholar 

  74. Lai EC, Chu KM, Lo CY et al (1992) Choice of palliation for malignant hilar obstruction. Am J Surg 163:208–212

    PubMed  CAS  Google Scholar 

  75. Lamere JS, Stoker J, Dees J et al (1987) Non-surgical palliative treatment of patients with malignant biliary obstruction: the place of endoscopic and percutaneous drainage. Clin Radiol 38:603–608

    Google Scholar 

  76. Schima W, Prokesch R, Osterreicher C et al (1997) Biliary wall-stent endoprosthesis in malignant hilar obstruction: long-term results with regard to the type of obstruction. Clin Radiol 52:213–219

    PubMed  CAS  Google Scholar 

  77. Peters RA, Williams SG, Lombard M et al (1997) The management of high-grade hilar structures by endoscopic insertion of self-expanding metal endoprosthesis. Endoscopy 29:10–16

    PubMed  CAS  Google Scholar 

  78. O’Brien S, Hatfield AR, Craig PI et al (1995) A three year follow up of self-expanding metal stents in the endoscopic palliation of long-term survivors with malignant biliary obstruction. Gut 36:618–621

    PubMed  Google Scholar 

  79. Becker CD, Glattie A, Mailbach R et al (1993) Percutaneous palliation of malignant obstructive jaundice with wall stent endoprosthesis: follow-up and reintervention in patients with hilar and non-hilar obstruction. J Vasc Interv Radiol 4:597–604

    PubMed  CAS  Google Scholar 

  80. Pitt HA (1993) Proximal bile duct: resection and palliation. In: Daly JM, Cady B (eds) Atlas of surgical oncology. Mosby-Year Book, St. Louis, pp 417–437

    Google Scholar 

  81. Yeo CJ, Pitt HA, Cameron JL (1990) Cholangiocarcinoma. Surg Clin North Am 70:1429–1447

    PubMed  CAS  Google Scholar 

  82. Ahrendt SA, Pitt HA (1993) Cholangiocarcinoma. In: Niederhuber JE (ed) Current therapy in oncology. Mosby-Year Book, St. Louis, pp 410–414

    Google Scholar 

  83. Lillemoe KD, Pitt HA, Kaufmann SL et al (1989) Acute cholecystitis occurring as a complication of percutaneous transhepatic drainage. Surg Gynecol Obstet 168:348–352

    PubMed  CAS  Google Scholar 

  84. Crist DW, Kadir S, Cameron JL (1987) Proximal biliary tract reconstruction: the value of preoperatively placed percutaneous biliary catheters. Surg Gynecol Obstet 165:421–426

    PubMed  CAS  Google Scholar 

  85. Stain SC, Baer HU, Dennison AR et al (1992) Current management of hilar cholangiocarcinoma. Surg Gynecol Obstet 175:579–588

    PubMed  CAS  Google Scholar 

  86. Ouchi K, Matsuno S, Sato T (1989) Long-term survival in carcinoma of the biliary tract. Arch Surg 124:248–252

    PubMed  CAS  Google Scholar 

  87. Bengmark S, Ekberg H, Evander A et al (1988) Major liver resection for hilar cholangiocarcinoma. Ann Surg 207:120–128

    PubMed  CAS  Google Scholar 

  88. Fortner JG, Vitelli CE, Maclean BJ (1989) Proximal extrahepatic bile duct tumors: analysis of a series of 52 consecutive patients treated over a period of 13 years. Arch Surg 124:1275–1282

    PubMed  CAS  Google Scholar 

  89. Lai ECS, Tompkins RK, Roslyn JJ et al (1987) Proximal bile duct cancer: quality of survival. Ann Surg 205:111–118

    PubMed  CAS  Google Scholar 

  90. Hadjis NS, Blenkhard JI, Alexander N et al (1990) Outcome of radical surgery in hilar cholangiocarcinoma. Surgery 107:597–604

    PubMed  CAS  Google Scholar 

  91. Boerma EJ (1990) Research into the results of resection of hilar bile duct cancer. Surgery 108:572–580

    PubMed  CAS  Google Scholar 

  92. Baer HU, Stain SC, Dennison AR et al (1993) Improvements in survival by aggressive resections of hilar cholangiocarcinoma. Ann Surg 217:20–27

    PubMed  CAS  Google Scholar 

  93. Vauthey JN, Baer HU, Guastella T et al (1993) Comparison of outcome between extended and nonextended liver resections for neoplasms. Surgery 114:968–975

    PubMed  CAS  Google Scholar 

  94. Kawasaki S, Makuuchi M, Miyagawa S et al (1994) Radical ­operation after portal embolization for tumor of hilar bile duct. J Am Coll Surg 178:480–486

    PubMed  CAS  Google Scholar 

  95. Nagino M, Nimura Y, Kamiya J et al (1995) Right or left trisegmental portal vein embolization before hepatic trisegmentectomy for hilar bile duct carcinoma. Surgery 117:677–681

    PubMed  CAS  Google Scholar 

  96. Nimura Y, Hayakawa N, Kamiya J et al (1991) Combined portal vein and liver resection for carcinoma of the biliary tract. Br J Surg 78:727–731

    PubMed  CAS  Google Scholar 

  97. Reding R, Buard JL, Lebeau G et al (1991) Surgical management of 552 carcinomas of the extrahepatic bile ducts: results of the French Surgical Association survey. Ann Surg 213:236–241

    PubMed  CAS  Google Scholar 

  98. Sugiura Y, Nakamura S, Iida S et al (1994) Extensive resection of the bile ducts combined with liver resection for cancer of the main hepatic duct junction: a cooperative study of the Keio Bile Duct Cancer Study Group. Surgery 115:445–451

    PubMed  CAS  Google Scholar 

  99. Washburn WK, Lewis DW, Jenkins RL (1995) Aggressive surgical resection for cholangiocarcinoma. Arch Surg 130:270–276

    PubMed  CAS  Google Scholar 

  100. Cameron JC (1990) Atlas of surgery, vol 1. B.C. Decker, Philadelphia

    Google Scholar 

  101. Guthrie CM, Haddock G, de Beaux AC et al (1993) Changing trends in the management of extrahepatic cholangiocarcinoma. Br J Surg 80:1434–1439

    PubMed  CAS  Google Scholar 

  102. Lillemoe KD, Sauter PK, Pitt HA et al (1993) Current status of surgical palliation of periampullary carcinoma. Surg Gynecol Obstet 176:1–10

    PubMed  CAS  Google Scholar 

  103. Casavilla FA, Marsh JW, Iwatsuki S et al (1997) Hepatic resection and transplantation for peripheral cholangiocarcinoma. J Am Coll Surg 195:429–436

    Google Scholar 

  104. Klempnauer J, Ridder GJ, von Wasielewski R et al (1997) Resectional surgery of hilar cholangiocarcinoma: a multivariate analysis of prognostic factors. J Clin Oncol 15:947–954

    PubMed  CAS  Google Scholar 

  105. Hayes JK Jr, Sapozink MD, Miller FJ (1988) Definitive radiation therapy in bile duct carcinoma. Int J Radiat Oncol Biol Phys 15:735–740

    PubMed  Google Scholar 

  106. Verbeek PC, van Leeuwen DJ, van der Heyde MN et al (1991) Does additive radiotherapy after hilar resection improve survival of cholangiocarcinoma: an analysis in sixty-four patients. Ann Chir 45:350–354

    PubMed  CAS  Google Scholar 

  107. Shiina T, Mikuriya S, Uno T et al (1992) Radiotherapy of cholangiocarcinoma: the roles for primary and adjuvant therapies. Cancer Chemother Pharmacol 31(Suppl):S115–S118

    PubMed  Google Scholar 

  108. Ede RJ, Williams SJ, Hatfield ARW et al (1989) Endoscopic management of inoperable cholangiocarcinoma using iridium-192. Br J Surg 76:867–871

    PubMed  CAS  Google Scholar 

  109. Koyama K, Tanaka J, Sato S et al (1989) New strategy for treatment of carcinoma of the hilar bile duct. Surg Gynecol Obstet 168:523–529

    PubMed  CAS  Google Scholar 

  110. Pitt HA, Nakeeb A, Abrams RA et al (1995) Perihilar cholangiocarcinoma: postoperative radiotherapy does not improve survival. Ann Surg 221:788–798

    PubMed  CAS  Google Scholar 

  111. Minsky BD, Kemeny N, Armstrong JG et al (1991) Extrahepatic biliary system cancer: an update of a combined modality approach. Am J Clin Oncol 14:433–439

    PubMed  CAS  Google Scholar 

  112. Koyama K, Tanaka J, Sato Y et al (1993) Experience in twenty patients with carcinoma of hilar bile duct treated by resection, targeting chemotherapy and intercavitary irradiation. Surg Gynecol Obstet 176:239–245

    PubMed  CAS  Google Scholar 

  113. Robertson JM, Lawrence TD, Dworzanin LM et al (1993) Treatment of primary hepatobiliary cancer with conformal radiation therapy and regional chemotherapy. J Clin Oncol 11:1286–1292

    PubMed  CAS  Google Scholar 

  114. Whittington R, Neuberg D, Teste WJ et al (1995) Protracted intravenous fluorouracil infusion with radiation therapy in the management of localized pancreaticobiliary carcinoma: a phase I Eastern Cooperative Oncology Group trial. J Clin Oncol 13:227–234

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Surgery, University of Pittsburgh, UPMC Cancer Center, 9100 Babcock Blvd, Pittsburgh, PA, 15090, USA

    Steven A. Ahrendt

Authors
  1. Steven A. Ahrendt
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Thomas H. Magnuson
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Steven A. Ahrendt .

Editor information

Editors and Affiliations

  1. School of Medicine, Department of Surgery, Yale University, New Haven, 06520, Connecticut, USA

    Ronnie Ann Rosenthal

  2. Downstate Medical Center, State University of New York, Clarkson Ave. 450, Brooklyn, 11203, New York, USA

    Michael E. Zenilman

  3. , Chairman, Department of Surgery, Sinai Hospital, 2401 West Belvedere Avenue, Baltimore, 21215, Maryland, USA

    Mark R. Katlic

Rights and permissions

Reprints and permissions

Copyright information

© 2011 Springer Science+Business Media, LLC

About this chapter

Cite this chapter

Ahrendt, S.A., Magnuson, T.H. (2011). Malignant Diseases of the Gallbladder and Bile Ducts. In: Rosenthal, R., Zenilman, M., Katlic, M. (eds) Principles and Practice of Geriatric Surgery. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-6999-6_74

Download citation

  • DOI: https://doi.org/10.1007/978-1-4419-6999-6_74

  • Published:

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4419-6998-9

  • Online ISBN: 978-1-4419-6999-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation