Diagnosis and Staging of Cholangiocarcinoma
Cholangiocarcinoma which is often diagnosed late due to non-specific clinical presentation is the most common biliary tract malignancy. In general, accurate staging is crucial to identifying patients with early disease who may be amenable to surgery with curative intent or locally advanced disease for which locoregional treatment approaches may be relevant. Furthermore, accurate diagnosis is crucial to guiding systemic treatment in the adjuvant or palliative setting. Findings on detailed radiological examination with CT and/or MRI could be suggestive of the diagnosis and sufficient for staging, while laparoscopy is at times necessary to exclude intra-abdominal metastases. However, the role of PET requires further evaluation. Invasive techniques such as ERCP, SpyGlass endoscopy and PTC have been found useful for biliary tract evaluation and for therapeutic relief of biliary tract obstruction. These biliary intervention techniques and EUS-FNA have also been found useful for obtaining a confirmatory histological diagnosis. This chapter subsequently discusses the diagnosis and staging of cholangiocarcinoma in some detail with some future perspective.
KeywordsCholangiocarcinoma CT Endoscopy Histology Liver Marker Metastases MRI Radiology Staging
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