Surgery for cholangiocarcinoma

Cholangiocarcinoma is a cancer arising from bile duct epithelium and commonly occurs in the main bile duct or at the bile duct confluence. The patients present obstructive jaundice and often have advanced disease. Treatment in the past has frequently consisted of palliative measures aimed at relieving jaundice either by surgical bypass or by endoscopic or percutaneous drainage usually in combination with stenting. A better understanding of the ways of invasion of the pathology of cholangiocarcinoma together with improvements in surgical techniques and perioperative management have lead to an increase in the number of patients in whom resection may be contemplated. Resection offers the only chance of cure and the best chance of long-term survival. Current problems associated with resection of hilar cholangiocarcinoma are discussed in this review article.