Contemporary Surgical Treatment for Management of Cholangiocarcinoma

Abstract

Cholangiocarcinoma is the second most common cause of liver cancer and is often in advanced stages at the time of diagnosis. The disease is classified and treated by anatomic location - distal, perihilar, and intrahepatic. Diagnosis and staging workup consists of laboratory analysis including liver function, bilirubin, and tumor markers, as well as cross sectional imaging and endoscopic evaluation. Early multidisciplinary management between Hepatology, Oncology, and Surgery teams is necessary to optimize outcomes. Currently, only patients with perihilar cholangiocarcinoma are eligible for wait-list prioritization at liver transplant based on the Mayo Clinic criteria. New evidence may support the extension of eligibility for liver transplant to intrahepatic cholangiocarcinoma. As such, expanded transplant exception criteria have been proposed. Continued advances in medical and radiation therapy along with liver transplant promise to increase the treatment options and survival from patients with cholangiocarcinoma.