[Primary carcinoma of the middle and distal third of the common bile duct, diagnosis, treatment and results].

The authors present a series of 21 patients with primary carcinoma of the middle and distal third of the extrahepatic biliary tract observed between 1981 and 1994. Indications and limits of the adopted diagnostic protocol and the selection criteria of the patients, identified by evaluating the preoperative resecability, are discussed. The indications for therapy considered the location of the neoplasia and the definitive staging obtained with the intraoperative ultrasonography and the histopathological examination. Seventy six percent of the operations were curative and the mean survival was 40 months range 13-120 mth for patients with tumor of the middle third and of 33 months range 10-133 mth for patients with tumor of the distal third. Survival results in patients who underwent palliative surgery seem to be similar to those obtained with non surgical palliative methods.