Chapter 53: Biliary Tract- Cholangiocarcinoma Flashcards

1
Q

What is it?

A

Malignancy of the extrahepatic or intrahepatic ducts—primary bile duct cancer

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2
Q

What is the histology?

A

Almost all are adenocarcinomas

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3
Q

Average age at diagnosis?

A

≈65 years, equally affects male/female

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4
Q

What are the signs and symptoms?

A

Those of biliary obstruction: jaundice, pruritus, dark urine, clay-colored stools,cholangitis

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5
Q

What is the most common location?

A

Proximal bile duct

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6
Q

What are the risk factors?

A
  • Choledochal cysts
  • Ulcerative colitis
  • Thorotrast contrast dye (used in 1950s)
  • Sclerosing cholangitis
  • Liver flukes (clonorchiasis)
  • Toxin exposures (e.g., Agent Orange)
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7
Q

What is a Klatskin tumor?

A

Tumor that involves the junction of the right and left hepatic ducts

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8
Q

What are the diagnostic tests of choice?

A

Ultrasound, CT scan, ERCP/PTC with biopsy/brushings for cytology, MRCP

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9
Q

What is an MRCP?

A

MRI with visualization of pancreatic and bile ducts

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10
Q

What is the management of proximal bile duct cholangiocarcinoma?

A

Resection with Roux-en-Y hepaticojejunostomy (anastomose bile ducts to jejunum) ± unilateral hepatic lobectomy

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11
Q

What is the management of distal common bile duct cholangiocarcinoma?

A

Whipple procedure

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