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Semin Liver Dis 2004; 24(2): 165-175
DOI: 10.1055/s-2004-828893
Copyright © 2004 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Endoscopic Management of Cholangiocarcinoma

Emad M. Abu-Hamda1 , 2 , Todd H. Baron2
  • 1Professor of Medicine, Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, Minnesota
  • 2Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, Minnesota
Further Information

Publication History

Publication Date:
11 June 2004 (online)

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Cholangiocarcinoma (CCA) is an uncommon malignant tumor arising from the biliary epithelium. The incidence increases with age and usually affects individuals in their 6th or 7th decade of life. Those patients with underlying risk factors such as primary sclerosing cholangitis (PSC) and choledochal cysts generally present 2 decades earlier. Most patients clinically present with painless jaundice; however, other common symptoms include pruritis, weight loss, and abdominal pain. Although surgical resection offers the only hope for cure, most patients are found to have unresectable disease on initial presentation and have an extremely grim prognosis. This has led to an emphasis on the role of palliative care, with relief of biliary obstruction, in the management of these patients. Surgical bypass was once the primary means of palliation of jaundice in patients with unresectable cholangiocarcinoma but in the last 2 decades has been superseded by less invasive and less morbid nonsurgical procedures such as endoscopic and percutaneous biliary stent placement. Newer modalities of palliation such as endoscopic delivery of photodynamic therapy and high-intensity ultrasound therapy are emerging nonsurgical modalities that may result in improved survival and may play a future role as an adjunctive therapy to surgical resection.

KEYWORDS

Cholangiocarcinoma - endoscopic retrograde cholangiopancreatography - biliary tract neoplasms - stents - magnetic resonance imaging

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Todd H BaronM.D. 

200 First Street SW, Charlton 8

Rochester, MN 55905

Email: baron.todd@mayo.edu