Biliary Cancers

Question 1

How is diagnosis of biliary cancers made?

Answer 1

Radiological investigations & pathomorphological assessment

Final pathological Dx needed before Chemo/RT/non-surgical oncological therapy.
** Not critical for planning surgery in patients with characteristic findings of resectable biliary cancers **

Question 2

Risk factors for cholangiocarcinomas

Answer 2

Primary sclerosing cholangitis (30% of all cholangiocarcinomas)
Congenital anomalies of biliary tree (eg. Choked octal cysts)
Liver fluke disease –> chronic inflammation of bile duct
Hepatolithiasis
Toxins
Lych Syndrome, Biliary papilloma toss
Chronic liver cirrhosis
DM
Obesity metabolic syndrome
HIV

Question 3

Name the liver fluke that causes cholangioCA

Answer 3

Opisthorchis Viverrini

Question 4

Contraindications to Surgery in cholangiocarcinomas?

Answer 4

Vascular involvement
Distant spread
Extent of local spread