RECURRENT CANCER OF THE COMMON BILE DUCT AND PERIAMPULLARY REGION

THE PROBLEM of recurrent cancer in the upper gastrointestinal and biliary tracts has not created the surgical unrest that equally malignant lesions on the surface of the body or in the musculoskeletal system have evoked. The defeatist attitude regarding the prognosis following the reresection of gastric cancer has been manifest in cancer producing biliary obstruction, and most surgeons do not feel justified in performing an operation in either area for recurrence offering a major risk of morbidity or mortality. It is an incontrovertible fact that the radical operation for neoplastic biliary obstruction is attended by a high mortality rate and a discouraging salvage. As previously stated in regard to the problem of resection in the face of recurrence of gastric cancer,¹ secondary resections of locally recurring lesions afford patients greater comfort with a more extended span of life than other surgical and nonsurgical methods of palliation and in an