Cholangiocarcinoma; clinical features and diagnosis ( Part One)

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Extrahepatic cholangiocarcinomas, whether in the lower duct or in the

hilum, present with painless jaundice or jaundice with mild pain in

more than 90% of cases. Intrahepatic cholangiocarcinomas usually

present consequent to detection of a mass or abdominal fullness by the

patient or as upper abdominal discomfort or pain. Preoperative

evaluation typically includes right upper quadrant ultrasound, dynamic

CT scan, MRCP (in centers with technical expertise in this procedure)

and/or ERCP with brushing/biopsy. Tumor markers such as CA 19-9 can be

useful in conjunction with biopsy or brushings to confirm the

diagnosis. If a tissue diagnosis cannot be confirmed, ultrasound or

CT-guided percutaneous biopsy should be considered.

A review of clinical features and diagnosis of cholangiocarcinomas has

been posted on :

http://www.surgerysearch.blogspot.com/

Dr. Jitendra Agrawal, Kanpur, India.