Clinical presentation, diagnosis and survival of resected distal bile duct cancer

Alessandro Zerbi, Gianpaolo Balzano, Biagio E. Leone, Enzo Angeli, Paolo Veronesi, Valerio Di Carlo

Research output: Contribution to journalArticlepeer-review


The aim of the study was the definition of the clinical features and survival of 27 resected cases of distal bile duct carcinoma. This neoplasm accounted for 14% of all periampullary malignancies treated by pancreaticoduodenectomy between 1990 and 1996. Jaundice was present in 96% of patients, but was the first symptom only in 78%. Preoperative investigations allowed to recognize distal bile duct cancer in a minority of patients (41%). Operative mortality and morbidity were 3.7 and 44%, respectively. Most patients (88%) were assigned to UICC stage IV-A. Postoperative survival was not significantly better than survival of 101 patients undergoing pancreaticoduodenectomy for pancreatic ductal carcinoma; median survival was 22 months, with a 13% 5-year survival rate. Determinants of a better prognosis were UICC stage <IV-A (p = 0.05) and absence of lymphatic invasion (p <0.01); prognostic significance of nodal involvement, tumor grading, perineural invasion, tumor size, pylorus preservation and adjuvant therapies could not be proven. Lymphatic invasion was the strongest determinant of survival on multivariate analysis (p <0.01).

Original languageEnglish
Pages (from-to)410-416
Number of pages7
JournalDigestive Surgery
Issue number5
Publication statusPublished - 1998


  • Bile duct cancer
  • Jaundice
  • Lymphatic invasion
  • Pancreatic cancer
  • Pancreatoduodenectomy
  • Periampullary cancer

ASJC Scopus subject areas

  • Surgery


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