Cholangiocarcinoma diagnosis and preoperative evaluation.docVIP

 PAGE \* MERGEFORMAT 10 Cholangiocarcinoma diagnosis and preoperative evaluation Cholangiocarcinoma is a rare malignant tumor. Cholangiocarcinoma diagnosis and preoperative assessment of need a complete clinical data, including: hepatobiliary imaging examination, tumor markers and histological examination. Surgical removal of lesions are completely cured only chance of cholangiocarcinoma, the results depend on the superb technology and the patient’s choice, but fewer patients can be surgically removed. The best treatment of cholangiocarcinoma measures involving a precise preoperative diagnosis, clinical staging and assessment. 1 Classification of cholangiocarcinoma According to anatomical location, can be divided into intrahepatic bile duct or extrahepatic bile duct cancer. This classification is reasonable, since both the clinical, pathological, and epidemiological differences. However, about 60% to 70% of hilar cholangiocarcinoma originated in the type of tumor has been described as hilar cholangiocarcinoma (klatskin tumors); 20% ~ 30% from the distal common bile duct; 5% ~ 10 % originated in the liver parenchyma around the intrahepatic bile ducts [1]. International Classification of Diseases (ICD) code will be originated in intrahepatic bile duct and intrahepatic cholangiocarcinoma with hepatocellular carcinoma classified as primary liver cancer [2,3]. 1975 ~ 1999 epidemiological survey showed that: 92% of Klatskin tumors are classified as intrahepatic bile duct cancer [4]. At present, according to anatomy can be divided into intrahepatic bile duct, distal extrahepatic or hilar. Hilar lesions using Bismuth classification described in the following five categories: Ⅰ type: left hepatic duct confluence of the following; Ⅱ type: in the left hepatic duct confluence; Ⅲ a, Ⅲ b Type: blocking hepatic duct and right hepatic duct or left hepatic duct ; Ⅵ type: violation occurred or was multi-center, as well as around the hepatic duct confluence [5]. 2 cholan