Cholangiocarcinoma

Cholangiocarcinoma is the most common tumor of bile duct. Cholangiocarcinoma may involve the bile duct at liver hilum, lower CBD or intrahepatic biliary system. Hilar is the most common type of cholnagiocarcinoma

Rick factors are

  • Choledochal cyst
  • Clonorchis sinensis
  • Hepaticolithiasis
  • Primary sclerosing cholangitis
  • Biliary-enteric drainage procedures

Symptoms

  • Painless jaundice
  • Itching
  • Weight loss and anorexia
  • Fever and pain abdomen in the case of cholangitis

Diagnosis

  • Diagnosis is suspected when USG/CT/MRCP reveals obstruction of biliary system, and a mass around the CBD
    For tissue diagnosis, EUS – FNA, ERCP-brushings, and spyglass with biopsy are available options

Treatment

  • Surgery is the best option for resectable tumors
  • For unresectable hilar cholangiocarcinoma, chemo-radiotherapy followed by liver transplantation is the new treatment strategy.
  • For advanced tumors, ERCP and stenting can be done for palliation of jaundice/itching and fever

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