Surgical treatment of cholangiocarcinoma
Journal Title: Postępy Nauk Medycznych - Year 2011, Vol 24, Issue 1
Abstract
Cholangiocarcinoma (CC) is a malignant tumor originating from the biliary epithelium. It was first described by Maxim Fardel in 1840. CC is the second most common primary liver cancer after hepatocellular carcinoma. This represents about 3% of all cancers of the digestive system. Depending on the location and construction there are two types of CC: intrahepatic (Intrahepatic cholangiocarcinoma – ICC) derived from the intrahepatic bile ducts within the liver parenchyma and extrahepatic (Extrahepatic cholangiocarcinoma – ECC), originating from the extrahepatic bile ducts within the hepato-duodenal ligament and the gallbladder. Depending on the location the ECC are divided into the hilar (Klatskin tumor) and peripheral tumors. Klatskin tumor occurs most often and constitutes 60-70% of all CC. Surgical treatment of CC can be radical or palliative. The method of radical surgical treatment of CC depends mainly on the location of the tumor. In ICC partial liver resection without lymphadenectomy is recommended. In Klatskin tumor partial liver resection, cholecystectomy and excision of extrahepatic bile duct, and regional lymphadenectomy is recommended. In the peripheral ECC pancreatoduodenectomy is performed and it has the best prognosis among all types of CC. In some cases of the CC liver transplantation is used. Approximately 50% of patients with unresectable tumors or with a accompanying disease and non-possibility of an extensive resection palliative treatment is only possible to relieve symptoms and improve quality of life. Palliative treatment consists of decompression of jaundice (endoscopic prosthesis insertion, percutaneous transhepatic biliary drainage and surgical biliary drainage). Palliative surgical treatment includes the biliary drainage and biliary-enteric and gastro-intestinal anastomoses.
Authors and Affiliations
Paweł Lampe, Beata Jabłońska
Keywords
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