Cholangiocarcinoma Flashcards
What is cholangiocarcinoma ( CC)
Cancer of the biliary system
Where is CC most commonly found
Most common in the extra-hepatic ducts at the bifurcation of the right and left hepatic duct which are called klatskin tumours
What is the most common type of CC
95% are adenocarcinoma
Rest are Squamous cell carcinoma
What are the risk factors for CC
PSC Ulcerative colitis Infective Congenital Alcohol excess Toxins DM
What are the clinical features of CC
Most are asymptomatic but can get:
Obstructive jaundice
Cachexia
Courvoisers law
How would you investigate CC
Lab - LFT ( obstructive picture ), CEA, CA19-9
Radiological - USS, MRCP,ERCP, staging CT chest abdo pelvis
How would you manage CC
Surgical resection - only curative Tx
Intrahepatic and klatskin tumours require a partial hepatectomy + biliary tree reconstruction
Distal CBD: Whipple
Radiotherapy
Palliative Tx: Stenting using ERCP, palliative radiotherapy
What are the complications of CC
Biliary tract sepsis
Secondary biliary cirrhosis
