Multidisciplinary treatment for hilar and intrahepatic cholangiocarcinoma: A review of the general principles

Int J Surg. 2020 Oct:82S:77-81. doi: 10.1016/j.ijsu.2020.04.067. Epub 2020 May 4.

Abstract

Cholangiocarcinoma (CCA) is a rare but devastating malignancy that presents late, and associated with a high mortality if untreated. CCA is locally aggressive and located in close proximity to vital structures i.e. the portal vein and hepatic artery. A complete extirpation of the tumor including microscopically detectable disease R0 resection offers the best possibility of long-term survival in patients with CCA. As such, the surgical approach to achieve a R0 resection is dictated by the location of the tumor and the presence of underlying liver disease. The present article focuses on the general principles of the multidisciplinary treatment of hilar and intrahepatic CCA.

Keywords: Hepatic resection; Hilar cholangiocarcinoma; Intrahepatic cholangiocarcinoma; Neoadjuvant therapy; Orthotopic liver transplantation.

Publication types

  • Review

MeSH terms

  • Adult
  • Bile Duct Neoplasms / mortality
  • Bile Duct Neoplasms / pathology
  • Bile Duct Neoplasms / therapy*
  • Bile Ducts, Intrahepatic / pathology
  • Cholangiocarcinoma / mortality
  • Cholangiocarcinoma / pathology
  • Cholangiocarcinoma / therapy*
  • Female
  • Hepatic Artery / pathology
  • Humans
  • Klatskin Tumor / mortality
  • Klatskin Tumor / pathology
  • Klatskin Tumor / therapy*
  • Male
  • Middle Aged
  • Patient Care Team*
  • Portal Vein / pathology