Hilar cholangiocarcionoma; Is aggressively answered

Abstract

INTRODUCTION: Cholangiocarcinoma (CCA) is a malignant disease involving the billiary system with majority occurring in the hilar region. CCA demands prompt management because of its aggressive nature. MATERIALS AND METHODS: Patients who presented to Gastroenterology and hepatobiliary unit at NHSL and the Professorial Surgical Unit of NCTH from January 2011 to June 2015 were included in this study. Diagnosis was made by CT imaging, MRCP and ERCP. RESULTS: Total of 120 patients were diagnosed with CCA. The median age of presentation was 64 years (31-85) with 51.2% being males. Majority of 63 patients (52.1%) of CCA occurred in the hilar region with rest involving the common bile duct. Out of 63 hilar CCA 44 were classified according to the bismuth classification. 13/44 were type I, 7/44 were type II, 9/44 were of type III and 15/44 were of type IV. While 5 patients (7.9%) underwent hepatic resection, Majority of 40 patients (63.5 %) were stented with 9 (14.2%) being treated with Radiofrequency ablation (RFA). Survival was significant following surgery (P=0.027). Four patients who underwent surgery are currently followed up at NCTH. CONCLUSIONS: Surgery appears to be the effective treatment for CCA. Aggressive palliation with stenting seems beneficial.