Cholangiocarcinoma

Question 1

What is cholangiocarcinoma?

Answer 1

cancer of the biliary tree

Question 2

Where is the most common site of cholangiocarcinoma?

Answer 2

bifurcation of the right and left hepatic duct (klatskin tumour)

Question 3

What are cholangiocarcinomas histologically usually?

Answer 3

adenocarcinomas

Question 4

What are the risk factors for cholangiocarinomas?

Answer 4

Primary sclerosing cholangitis, Ulcerative colitis, infective, toxins, congenital, alcohol excess, Diabetes mellitus

Question 5

What are the clinical features of cholangiocarcinomas?

Answer 5

asymptomatic but then may have post- hepatic jaundice and pruritus with pale stools and dark urine, RUQ pain, early satiety, weight loss, anorexia and malaise, jaundice cachexia

Question 6

What are the differential diagnosis of cholangiocarcinoma?

Answer 6

obstructive choledocholithiasis, bule duct strictures, choledochal cyst, external compression from extra biliary tumours, benign biliary tumours, pancreatic tumours, primary biliary cirrhosis and PSC

Question 7

What are the investigations for cholangiocarinoma?

Answer 7

obstructive jaundice and tumour markers of CEA and CA19-9

Question 8

What are the radiological investigations for cholangiocarinoma?

Answer 8

ultrasound scanning, MRCP, ERCP, CT imaging

Question 9

What is the management for cholangiocarcinoma?

Answer 9

complete surgical resection, radiotherapy, stenting, surgical bypass

Question 10

What are the complications of cholangiocarcinoma?

Answer 10

increased biliary tract sepsis, secondary biliary cirrhosis