Neoplasie maligne della via biliare. Condotta diagnostica e trattamento chirurgico.

Biliary duct tumors seem to be increasing. Clinical picture and treatment differ according to the site. Local metastases, blood vessel invasion and spread along neural sheaths may be found especially in proximal biliary tract carcinoma, often referred to as Klatskin tumors, that develop together with a strong network of fibrotic connective tissue and are obviously not often easily resectable radically. Diagnosis of site of origin and spread are more exact today thanks to wider applications of combined newer diagnostic imaging and cholangiographic techniques. All patients should be operated on if the general condition permits: tumors of the lower bile ducts have the largest resectability rate. Extensive resection of the bile ducts combined with resection of the liver for carcinoma of the main hepatic duct junction can now be carried out with low operative mortality. The operative outcome for these patients is poor because of the low frequency of curative resections but recently there ha...