CARCINOMA OF THE BILE DUCTS.

Carcinoma of the major extrahepatic and intrahepatic bile ducts, although infrequently encountered, merits consideration in every patient having obstructive jaundice. The correct preoperative diagnosis is seldom made. The operative diagnosis is difficult because of the limited anatomical boundaries and the difficulty of thorough exploration of the ductal system. Malignant tumors of the ducts produce complete obstruction early in the course of the disease, in most instances. The proximity of the vital structures permits the tumors to grow to an inoperable state in a short period of time following the onset of symptoms. This study concerns malignant tumors of the extrahepatic and intrahepatic ducts, exclusive of the ampulla of Vater. Each tumor was histologically verified at operation or autopsy. In 1941, Kirschbaum and Kozoll 1 reported the findings regarding these tumors in 13,330 postmortem examinations from Cook County Hospital, Chicago. Our review concerns the bile duct tumors found at surgery or

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