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Diagnosis and Management of Intrahepatic and Extrahepatic Cholangiocarcinoma

  • Steven A. Curley
Part of the Cancer Treatment and Research book series (CTAR, volume 109)

Abstract

Cholangiocarcinomas are malignant tumors that arise from the epithelium of the intrahepatic or extrahepatic bile ducts. Cholangiocarcinomas are rare compared with hepatocellular carcinoma, comprising less than 10% of primary malignancies of the liver (1). In the United States, approximately 3,000 patients are diagnosed with cholangiocarcinoma annually (2). The autopsy incidence of cholangiocarcinoma is low also, being reported in 0.089–0.46% of necropsies (1). Cholangiocarcinomas are diagnosed most frequently in the fifth and sixth decades of life (3). There is only a slight male preponderance of cases of cholangiocarcinoma. Cholangiocarcinomas can arise at any site in the intra- or extrahepatic biliary system, but perihilar tumors comprise two-thirds of the cases of cholangiocarcinoma (3) (Fig. 1).

Keywords

Bile Duct Primary Sclerosing Cholangitis Hepatic Duct Choledochal Cyst Extrahepatic Bile Duct 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Anthony PP. Tumours and tumour-like lesions of the liver and biliary tract. In MacSween RNM, Anthony PP, Scheuer PJ (eds). Pathology of the Liver, 2nd ed. Edinburgh: Churchill Livingstone, 1987, p. 574.Google Scholar
  2. 2.
    Thuluvath PJ, Rai R, Venbrux AC, Yeo CJ. Cholangiocarcinoma: A review. Gastroenterologist 5:306–315, 1997.PubMedGoogle Scholar
  3. 3.
    Nakeeb A, Pitt HA, Sohn TA, et al. Cholangiocarcinoma: A spectrum of intrahepatic, perihilar, and distal tumors. Ann Surg 224:463–475, 1996.PubMedCrossRefGoogle Scholar
  4. 4.
    The Liver Cancer Study Group of Japan. Primary liver cancer in Japan. Cancer 54:1747–1755, 1984.CrossRefGoogle Scholar
  5. 5.
    Sorensen HT, Friis S, Olsen JH, et al. Risk of liver and other types of cancer in patients with cirrhosis: A nationwide cohort study in Denmark. Hepatology 28:921–925, 1998.PubMedCrossRefGoogle Scholar
  6. 6.
    Schwartz DA. Cholangiocarcinoma associated with liver fluke infection: A preventable source of morbidity in Asian immigrants. Am J Gastroenterol 81:76–79, 1986.PubMedGoogle Scholar
  7. 7.
    Kurathong S, Lerdverasirikul P, Wonkpaitoon V, et al. Opisthorchis viverrini infection and cholangiocarcinoma. A prospective, case-controlled study. Gastroenterology 89:151–156, 1985.PubMedGoogle Scholar
  8. 8.
    Nakashima T, Okuda K, Kojiro M, et al. Primary liver cancer coincident with Schistosomiasis japonica. A study of 23 necropsies. Cancer 36:1483–1489, 1975.PubMedCrossRefGoogle Scholar
  9. 9.
    Kim KH, Kim CD, Lee HS, et al. Biliary papillary hyperplasia with Clonorchiasis resembling cholangiocarcinoma. Am J Gastroenterol 94:514–517, 1999.PubMedCrossRefGoogle Scholar
  10. 10.
    Nakanuma Y, Terada T, Tanka Y. Are hepatolithiasis and cholangiocarcinoma aetiologically related? A morphological study of 12 cases of hepatolithiasis associated with cholangiocarcinoma. Virchows Arch A Pathol Anat Histopathol 406:45–58, 1985.PubMedCrossRefGoogle Scholar
  11. 11.
    Thamavit W, Phamarapravati N, Sahaphong S, et al. Effects of dimethylnitrosamine on induction of cholangiocarcinoma in Opisthorchis vivemw-infected Syrian golden hamsters. Cancer Res 38:4634–4639, 1978.PubMedGoogle Scholar
  12. 12.
    Prempracha N, Tengchaisri T, Chawengkirttikul R, et al. Identification and potential use of a soluble tumor antigen for the detection of liver-fluke-associated cholangiocarcinoma induced in a hamster model. Int J Cancer 57:691–695, 1994.PubMedCrossRefGoogle Scholar
  13. 13.
    Landais P, Drunfeld JP, Droz D, et al. Cholangiocellular carcinoma in polycystic kidney and liver disease. Arch Intern Med 144:2274–2276, 1984.PubMedCrossRefGoogle Scholar
  14. 14.
    Voyles CR, Smadja C, Shands W, Blumgart LH. Carcinoma in choledochal cysts. Age-related incidence. Arch Surg 118:986–988, 1983.PubMedCrossRefGoogle Scholar
  15. 15.
    Imamura M, Miyashita T, Tani T, et al. Cholangiocellular carcinoma associated with multiple liver cysts. Am J Gastroenterol 79:790–795, 1984.PubMedGoogle Scholar
  16. 16.
    Dayton MT, Longmire WP, Tompkins RK. Caroli’s disease: A premalignant condition? Am J Surg 145:41–48, 1983.PubMedCrossRefGoogle Scholar
  17. 17.
    Wee A, Ludwig L, Coffey RJ, et al. Hepatobiliary carcinoma associated with primary sclerosing cholangitis and chronic ulcerative colitis. Hum Pathol 16:719–726, 1985.PubMedCrossRefGoogle Scholar
  18. 18.
    Chen PH, Lo HW, Wang CS, et al. Cholangiocarcinoma in hepatolithiasis. J Clin Gastroenterol 6:539–547, 1984.PubMedCrossRefGoogle Scholar
  19. 19.
    Koga A, Ichimiya H, Yamaguchi, et al. Hepatolithiasis associated with cholangiocarcinoma, possible etiologic significance. Cancer 55:2826–2829, 1985.PubMedCrossRefGoogle Scholar
  20. 20.
    Yoshimoto H, Ikeda S, Tanaka M, Matsumoto S. Intrahepatic cholangiocarcinoma associated with hepatolithiasis. Gastrointest Endosc 31:260–263, 1985.PubMedCrossRefGoogle Scholar
  21. 21.
    Chen MF, Jan YY, Wang CS, et al. A reappraisal of cholangiocarcinoma in patients with hepatolithiasis. Cancer 71:2461–2465, 1993.PubMedCrossRefGoogle Scholar
  22. 22.
    Chijiiwa K, Ichimaya H, Kuroki S, et al. Late development of cholangiocarcinoma after the treatment of hepatolithiasis. Surg Gynecol Obstet 177:279–282, 1993.PubMedGoogle Scholar
  23. 23.
    Robertson JF, Raine PA. Choledochal cyst: A 33 year review. Br J Surg 75:799–801, 1988.PubMedCrossRefGoogle Scholar
  24. 24.
    Lipsett PA, Pitt HA, Colombani PM, et al. Choledochal cyst disease. A changing pattern of presentation. Ann Surg 220:644–652, 1994.PubMedCrossRefGoogle Scholar
  25. 25.
    Cherqui D, Tantawi B, Alon R, et al. Relationships between sclerosing cholangitis, inflammatory bowel disease, and cancer in patients undergoing liver transplantation. Surgery 118:615–619, 1995.CrossRefGoogle Scholar
  26. 26.
    Rosen CB, Nagorney DM, Wiesner RH, et al. Cholangiocarcinoma complicating primary sclerosing cholangitis. Ann Surg 213:21–25, 1991.PubMedCrossRefGoogle Scholar
  27. 27.
    Van Laethem JL, Deviere J, Bourgeois N, et al. Cholangiographie findings in deteriorating primary sclerosing cholangitis. Endoscopy 27:223–228, 1995.PubMedCrossRefGoogle Scholar
  28. 28.
    Nichols JC, Gores GJ, LaRusso NF, et al. Diagnostic role of serum CA 19–9 for cholangiocarcinoma in patients with primary sclerosing cholangitis. Mayo Clin Proc 68:874–879, 1993.PubMedCrossRefGoogle Scholar
  29. 29.
    Ramage JK, Donaghy A, Farrant JM, et al. Serum tumor markers for the diagnosis of cholangiocarcinoma in primary sclerosing cholangitis. Gastroenterology 108:865–869, 1995.PubMedCrossRefGoogle Scholar
  30. 30.
    Ito Y, Kojiro J, Nakashima T, Mori T. Pathomorphology characteristics of 102 cases of thorotrast-related hepatocellular carcinoma, cholangiocarcinoma and hepatic angiosarcoma. Cancer 62:1153–1162, 1988.PubMedCrossRefGoogle Scholar
  31. 31.
    Rubel LR, Ishak KG. Thorotrast-associated cholangiocarcinoma. An epidemiologic and clinicopathologic study. Cancer 50:1408–1415, 1982.PubMedCrossRefGoogle Scholar
  32. 32.
    Sell S, Dunsford HA. Evidence for the stem cell origin of hepatocellular carcinoma and cholangiocarcinoma. Am J Pathol 134:1347–1363, 1989.PubMedGoogle Scholar
  33. 33.
    Okada Y, Jinno K, Moriwaki S, et al. Expression of ABH and Lewis blood group antigens in combined hepatocellular-cholangiocarcinoma. Possible evidence for the hepatocellular origin of combined hepatocellular-cholangiocarcinoma. Cancer 60:345–352, 1985.CrossRefGoogle Scholar
  34. 34.
    Goodman ZD, Ishak KG, Longloss JM, et al. Combined hepatocellular-cholangiocarcinoma. A histologic and immunohistochemical study. Cancer 55:124–135, 1985.PubMedCrossRefGoogle Scholar
  35. 35.
    Ding SF, Delhanty JD, Bowles L, et al. Loss of constitutional heterozygosity on chromosomes 5 and 17 in cholangiocarcinoma. Br J Cancer 67:1007–1010, 1993.PubMedCrossRefGoogle Scholar
  36. 36.
    Sturm PDJ, Baas LO, Clement MJ, et al. Alterations of the p53 tumor-suppressor gene and K-ras oncogene in perihilar cholangiocarcinomas from a high-incidence area. Int J Cancer 78:695–698, 1998.PubMedCrossRefGoogle Scholar
  37. 37.
    Wattanasirichaigoon S, Tasanakhajorn U, Jesadapatarakul S. The incidence of K-ras codon 12 mutations in cholangiocarcinoma detected by polymerase chain reaction technique. J Med Assoc Thai 81:316–323, 1998.PubMedGoogle Scholar
  38. 38.
    Petmitr S, Pinlaor S, Thousungnoen A, et al. K-ras oncogene and p55 gene mutations in cholangiocarcinoma from Thai patients. Southeast Asian J trop Med Public Health 29:71–75, 1998.PubMedGoogle Scholar
  39. 39.
    Terada T, Ashida K, Endo K, et al. c-erbB-2 protein is expressed in hepatolithiasis and cholangiocarcinoma. Histopathology 33:325–331, 1998.PubMedCrossRefGoogle Scholar
  40. 40.
    Celli A, Que FG. Dysregulation of apoptosis in the cholangiopathies and cholangiocarcinoma. Sem Liver Dis 18:177–185, 1998.CrossRefGoogle Scholar
  41. 41.
    Pitt H, Dooley W, Yeo C, Cameron J. Malignancies of the biliary tree. Curr Probl Surg 32:1–90, 1995.PubMedCrossRefGoogle Scholar
  42. 42.
    Jalanko H, Kuusela P, Roberts P, et al. Comparison of a new tumor marker, CA 19–9T, with ot-fetoprotein and carcinoembryonic antigen in patients with upper gastrointestinal disease. J Clin Pathol 37:218–222, 1984.PubMedCrossRefGoogle Scholar
  43. 43.
    Oldenburg WA, Van Heerden PA, Sizemore GW, et al. Hypercalcemia and primary hepatic tumors. Arch Surg 117:1363–1366, 1992.CrossRefGoogle Scholar
  44. 44.
    Davis JM, Sadasivan R, Dwyer T, et al. Case report: Cholangiocarcinoma and hypercalcemia. AM J Med Sei 307:350–352, 1994.CrossRefGoogle Scholar
  45. 45.
    Weinbren K, Mutum SS. Pathological aspects of cholangiocarcinoma. J Pathol 139:217–238, 1983.PubMedCrossRefGoogle Scholar
  46. 46.
    Aoki K, Takayasu K, Kawano T, et al. Combined hepatocellular carcinoma and cholangiocarcinoma: Clinical features and computed tomographic findings. Hepatology 18:1090–1095, 1993.PubMedCrossRefGoogle Scholar
  47. 47.
    Yamamoto M, Takasaki K, Yoshikawa T, Ueno K, Nakano M. Does gross appearance indicate prognosis in intrahepatic cholangiocarinoma? J Surg Oncol 69:162–167, 1998.PubMedCrossRefGoogle Scholar
  48. 48.
    Bonetti F, Chilosi M, Posa R, et al. Epithelial membrane antigen expression in cholangiocarcinoma. A useful immunohistochemical tool for differential diagnosis with hepatocarcinoma. Virchows Arch A Pathol Anat Histopathol 401:307–313, 1983.PubMedCrossRefGoogle Scholar
  49. 49.
    Pastolero GC, Wakabayashi T, Oka T, Mori S. Tissue polypeptide antigen: A marker antigen differentiating cholangiolar tumors from other hepatic tumors. Am J Clin Pathol 87:168–173, 1987.PubMedGoogle Scholar
  50. 50.
    Sasaki A, Kawano K, Aramaki M, et al. Immunohistochemical expression of cyto keratins in intrahepatic cholangiocarcinoma and metastatic adenocarcinoma of the liver. J Surg Oncol 70:103–108, 1999.PubMedCrossRefGoogle Scholar
  51. 51.
    Colli A, Cocciolo M, Mumoli N, et al. Peripheral intrahepatic cholangiocarcinoma: ultrasound findings and differential diagnosis from hepatocellular carcinoma. Eur J Ultrasound 7:93–99, 1998.PubMedCrossRefGoogle Scholar
  52. 52.
    Kuszyk BS, Soyer P, Bluemke DA, Fishman EK. Intrahepatic cholangiocarcinoma: The role of imaging in detection and staging. Critical Rev in Diag Imaging 38:59–88, 1997.Google Scholar
  53. 53.
    Feydy A, Vilgrain V, Denys A, et al. Helical CT assessment in hilar cholangiocarcinoma: Correlation with surgical and pathologic findings. AJR 172:73–77, 1999.PubMedCrossRefGoogle Scholar
  54. 54.
    Tillich M, Mischinger HJ, Preisegger KH, et al. Multiphasic helical CT in diagnosis and staging of hilar cholangiocarcinoma. AJR 171:651–658, 1998.PubMedCrossRefGoogle Scholar
  55. 55.
    Han JK, Choi BI, Kim TK, Kim SW, Han MC, Yeon KM. Hilar cholangiocarcinoma: Thin-section spiral CT findings with Cholangiographie correlation. Radiographics 17:1475–1485, 1997.PubMedGoogle Scholar
  56. 56.
    Okuda K, Ohto M, Tsuchiya Y. The role of ultrasound, percutaneous transhepatic cholangiography, computed tomographic scanning, and magnetic resonance imaging in the preoperative assessment of bile duct cancer. World J Surg 12:18–26, 1988.PubMedCrossRefGoogle Scholar
  57. 57.
    Garber ST, Donald J J, Lees WR. Cholangiocarcinoma: Ultrasound features and correlation of tumor position with survival. Abdom Imaging 18:66–69, 1993.PubMedCrossRefGoogle Scholar
  58. 58.
    Neumaier CE, Bertolotto M, Perrone R, Martinoli C, et al. Staging of hilar cholangiocarcinoma with ultrasound. J Clin Ultrasound 23:173–178, 1995.PubMedCrossRefGoogle Scholar
  59. 59.
    Kusano T, Shimabukuro M, Tamai O, et al. The use of intraoperative ultrasonography for detecting tumor extension in bile duct carcinoma. Int Surg 82:44–48, 1997.PubMedGoogle Scholar
  60. 60.
    Fujita N, Noda Y, Kobayashi G, et al. Staging of bile duct carcinoma by EUSandlDUS. Endoscopy 30.A132-A 134, 1998.Google Scholar
  61. 61.
    Choi BI, Kim TK, Han JK. MRI of Clonorchiasis and cholangiocarcinoma. J MRI 8:359–366, 1998.Google Scholar
  62. 62.
    Worawattanakul S, Semelka RC, Noone TC, et al. Cholangiocarcinoma: Spectrum of appearances on MR images using current techniques. Magnetic Resonance Imaging 16:993–1003, 1998.PubMedCrossRefGoogle Scholar
  63. 63.
    Neri E, Boraschi P, Braccini G, et al. MR virtual endoscopy of the pancreaticobiliary tract. Magnetic Resonance Imaging 17:59–67, 1999.PubMedCrossRefGoogle Scholar
  64. 64.
    Elias E, Hamlyn AN, Jain S, et al. A randomized trial of percutaneous transhepatic cholangiography with the Chiba needle versus ERCP for bile duct visualization in jaundice. Gastroenterology 71:439–443, 1976.PubMedGoogle Scholar
  65. 65.
    Tanaka M, Ogawa Y, Matsumoto S, et al. The role of endoscopic retrograde cholangiopancreatography in preoperative assessment of bile duct cancer. World J Surg 12:27–32, 1988.PubMedCrossRefGoogle Scholar
  66. 66.
    Yamakawa T, Esguerra R, Kaneko H, et al. Percutaneous transhepatic endoprosthesis in malignant obstruction of the bile duct. World J Surg 12:78–84, 1988.PubMedCrossRefGoogle Scholar
  67. 67.
    Pitt HA, Gomes AS, Lois JF, et al. Does preoperative percutaneous biliary drainage reduce operative risk or increase hospital cost? Ann Surg 201:545–553, 1985.PubMedCrossRefGoogle Scholar
  68. 68.
    McPherson GAD, Benjamin IS, Hodjson HJF, et al. Preoperative percutaneous transhepatic biliary drainage: The results of a controlled trial. Br J Surg 71:371–375, 1984.PubMedCrossRefGoogle Scholar
  69. 69.
    Cameron JL, Broe P, Zuidema GD. Proximal bile duct tumors: Surgical management with silastic transhepatic biliary stents. Ann Surg 196:412–419, 1982.PubMedCrossRefGoogle Scholar
  70. 70.
    Crist DW, Kadir S, Cameron JL. The value of preoperatively placed percutaneous biliary catheters in reconstruction of the proximal part of the biliary tree. Surg Gynecol Obstet 165:421–424, 1987.PubMedGoogle Scholar
  71. 71.
    Soehendra N, Grimm H. Endoscopic retrograde drainage for bile duct cancer. World J Surg 12:85–90, 1988.PubMedCrossRefGoogle Scholar
  72. 72.
    Keiding S, Hansen SB, Rasmussen HH, et al. Detection of cholangiocarcinoma in primary sclerosing cholangitis by positron emission tomography. Hepatology 28:700–706, 1998.PubMedCrossRefGoogle Scholar
  73. 73.
    Voyles CR, Bowley NJ, Allison DJ, et al. Carcinoma of the proximal extrahepatic biliary tree, radiologic assessment and therapeutic alternatives. Ann Surg 197:188–194, 1983.PubMedCrossRefGoogle Scholar
  74. 74.
    Van Delden OM, de Wit LT, van Dijkum EJ, et al. Value of laparoscopic ultrasonography in staging of proximal bile duct tumors. J Ultrasound Med 16:7–12, 1997.PubMedGoogle Scholar
  75. 75.
    Roayaie S, Guarrera JV, Ye MQ, et al. Aggressive surgical treatment of intrahepatic cholangiocarcinoma: Predictors of outcomes. J Am Coll Surg 187:365–372, 1998.PubMedCrossRefGoogle Scholar
  76. 76.
    Lieser MJ, Barry K, Rowland C, et al. Surgical management of intrahepatic cholangiocarcinoma: A 31-year experience. J Hep Bil Pancr Surg 5:41–47, 1998.CrossRefGoogle Scholar
  77. 77.
    Sixth report. Liver Cancer Study Group of Japan. Primary liver cancer in Japan. Cancer 60:1400–1411, 1987.CrossRefGoogle Scholar
  78. 78.
    Liguory C, Canard JM. Tumours of the biliary system. Clin Gastroenterol 12:269–295, 1983.PubMedGoogle Scholar
  79. 79.
    Harrison LE, Fong Y, Klimstra DS, et al. Surgical treatment of 32 patients with peripheral intrahepatic cholangiocarcinoma. Br J Surg 85:1068–1070, 1998.PubMedCrossRefGoogle Scholar
  80. 80.
    Chou FF, Sheen-Chen SM, Chen CL, et al. Prognostic factors of resectable intrahepatic cholangiocarcinoma. J Surg Oncol 59:40–44, 1995.PubMedCrossRefGoogle Scholar
  81. 81.
    Pichlmayr R, Lamesch P, Weimann A, Tusch G, Ringe B. Surgical treatment of cholangiocellular carcinoma. World J Surg 19:83–88, 1995.PubMedCrossRefGoogle Scholar
  82. 82.
    Sasaki A, Aramaki M, Kawano K, et al. Intrahepatic peripheral cholangiocarcinoma: Mode of spread and choice of surgical treatment. Br J Surg 85:1206–1209, 1998.PubMedCrossRefGoogle Scholar
  83. 83.
    Sansalone CV, Colella G, Caccamo L, et al. Orthotopic liver transplantation for primary biliary tumors: Milan multicenter experience. Transplant Proc 26:3561–3563, 1994.PubMedGoogle Scholar
  84. 84.
    Goldstein RM, Stone M, Tillery GW, et al. Is liver transplantation indicated for cholangiocarcinoma? Am J Surg 166:768–771, 1993.PubMedCrossRefGoogle Scholar
  85. 85.
    Curley SA, Levin B, Rich TA. Liver and bile ducts. In Abeloff MD, Armitage JO, Lichter AS, Niederhuber JE (eds). Clinical Oncology. London: Churchill Livingston, 1995, p. 1305–1372.Google Scholar
  86. 86.
    Fardel D. Malignant neoplasms of the extrahepatic biliary ducts. Ann Surg 76:205–211, 1922.CrossRefGoogle Scholar
  87. 87.
    Altmeier WA, Gall EA, Zinninger MM, et al. Sclerosing carcinoma of the major intrahepatic bile ducts. Arch Surg 75:450–454, 1957.CrossRefGoogle Scholar
  88. 88.
    Klatskin G. Adenocarcinoma of the hepatic duct at its bifurcation within the porta hepatis. Am J Med 38:241–248, 1965.PubMedCrossRefGoogle Scholar
  89. 89.
    Sako K, Seitzinger GL, Garside E. Carcinoma of the extrahepatic bile ducts: Review of the literature and report of six cases. Surgery 41:416–422, 1957.Google Scholar
  90. 90.
    Landis SH, Murray T, Bolden S, Wingo PA. Cancer Statistics, 1999. CA-A Cancer Journal for Clinicians 49:8–31, 1999.PubMedCrossRefGoogle Scholar
  91. 91.
    Bismuth H, Castaing D, Traynor O. Resection or palliation: Priority of surgery in the treatment of hilar cancer. World J Surg 12:39–47, 1988.PubMedCrossRefGoogle Scholar
  92. 92.
    Nagorney DM, Donohue JH, Farnell MB, et al. Outcomes after curative resections of cholangiocarcinoma. Arch Surg 128:871–879, 1993.PubMedCrossRefGoogle Scholar
  93. 93.
    Nimura Y, Kamiya J, Nagino M, et al. Aggressive surgical treatment of hilar cholangiocarcinoma. J Hep Bil Pancr Surg 5:52–61, 1998.CrossRefGoogle Scholar
  94. 94.
    Burke EC, Jarnigan WR, Hochwald SN, et al. Hilar cholangiocarcinoma: Patterns of spread, the importance of hepatic resection for curative operation, and a presurgical clinical staging system. Ann Surg 228:385–394, 1998.PubMedCrossRefGoogle Scholar
  95. 95.
    Chung C, Bautista N, O’Connell TX. Prognosis and treatment of bile duct carcinoma. Am Surg 64:921–925, 1998.PubMedGoogle Scholar
  96. 96.
    Kayahara M, Nagakawa T, Ohta T, et al. Role of nodal involvement and the periductal soft-tissue margin in middle and distal bile duct cancer. Ann Surg 229:76–83, 1999.PubMedCrossRefGoogle Scholar
  97. 97.
    Tompkins RK, Thomas D, Wile A, et al. Prognostic factors in bile duct carcinoma. Ann Surg 194:447–457, 1981.PubMedCrossRefGoogle Scholar
  98. 98.
    Ouchi K, Suzuki M, Hashimoto L, et al. Histologic findings and prognostic factors in carcinoma of the upper bile duct. Am J Surg 157:552–556, 1989.PubMedCrossRefGoogle Scholar
  99. 99.
    Sakamoto E, Nimura Y, Hayakawa N, et al. The pattern of infiltration at the proximal border of hilar bile duct carcinoma: A histologic analysis of 62 resected cases. Ann Surg 227:405–411, 1998.PubMedCrossRefGoogle Scholar
  100. 100.
    Mittal B, Deutsch M, Iwatsuki S. Primary cancers of the extrahepatic biliary passages. Int J Radiât Oncol Biol Phys 11:849–854, 1985.PubMedCrossRefGoogle Scholar
  101. 101.
    Mizumoto R, Kawarada Y, Suzuki H. Surgical treatment of hilar carcinoma of the bile duct. Surg Gynecol Obstet 162:153–158, 1986.PubMedGoogle Scholar
  102. 102.
    Mizumoto R, Suzuki H. Surgical anatomy of the hepatic hilum with special reference to the caudate lobe. World J Surg 12:2–10, 1988.PubMedCrossRefGoogle Scholar
  103. 103.
    Bengmark S, Ekberg H, Evander A, et al. Major liver resection for hilar cholangiocarcinoma. Ann Surg 207:120–125, 1988.PubMedCrossRefGoogle Scholar
  104. 104.
    White TT. Skeletization resection and central hepatic resection in the treatment of bile duct cancer. World J Surg 12:48–51, 1988.PubMedCrossRefGoogle Scholar
  105. 105.
    Pinson CW, Rossi RL. Extended right hepatic lobectomy, left hepatic lobectomy, and skeletonization resection for proximal bile duct cancer. World J Surg 12:52–59, 1988.PubMedCrossRefGoogle Scholar
  106. 106.
    Washburn WK, Lewis WD, Jenkins RL. Aggressive surgical resection for cholangiocarcinoma. Arch Surg 130:270–276, 1995.PubMedCrossRefGoogle Scholar
  107. 107.
    Baer HU, Stain SC, Dennison AR, Eggers B, Blumgart LH. Improvements in survival by aggressive resections of hilar cholangiocarcinoma. Ann Surg 217:20–27, 1993.PubMedCrossRefGoogle Scholar
  108. 108.
    Nagino M, Nimura Y, Kamiya J, et al. Segmental liver resections for hilar cholangiocarcinoma. Hepatogastroenterology 45:7–13, 1998. 109.Google Scholar
  109. 109.
    Bismuth H, Corlette MB. Intrahepatic cholangioenteric anastomosis in carcinoma of the hilus of the liver. Surg Gynecol Obstet 140:170–178, 1975.PubMedGoogle Scholar
  110. 110.
    Hochwald SN, Burke EC, Jarnagin WR, et al. Association of preoperative biliary stenting with increased postoperative infectious complications in proximal cholangiocarcinoma. Arch Surg 134:261–266, 1999.PubMedCrossRefGoogle Scholar
  111. 111.
    Tsukada K, Yoshida K, Aono T, Koyama S, Shirai Y, Uchida K, Muto T. Major hepatectomy and pancreatoduodenectomy for advanced carcinoma of the biliary tract. Br J Surg 81:108–110, 1994.PubMedCrossRefGoogle Scholar
  112. 112.
    Cameron JL, Pitt HA, Zinner MJ, et al. Management of proximal cholangiocarcinomas by surgical resection and radiotherapy. Am J Surg 159:91–98, 1990.PubMedCrossRefGoogle Scholar
  113. 113.
    Alexandre JH, Dehni N, Bouillot JL. Stented hepaticojejunostomies after resection for cholangiocarcinoma allow access for subsequent diagnosis and therapy. Am J Surg 169:428–429, 1995.PubMedCrossRefGoogle Scholar
  114. 114.
    McMasters KM, Turtle TM, Leach SD, et al. Neoadjuvant chemoradiation enhances margin-negative resection rates for extrahepatic cholangiocarcinoma. Am J Surg 174:605–609, 1997.PubMedCrossRefGoogle Scholar
  115. 115.
    Ringe B, Wittekind C, Bechstein WO, et al. The role of liver transplantation in hepatobiliary malignancy. Ann Surg 209:88–98, 1989.PubMedCrossRefGoogle Scholar
  116. 116.
    O’Grady JG, Poison RJ, Rolles K, et al. Liver transplantation for malignant disease. Ann Surg 207:373–379, 1988.PubMedCrossRefGoogle Scholar
  117. 117.
    Funovics JM, Fritsch A, Herbst F, et al. Primary hepatic cancer - the role of limited resection and total hepatectomy with orthotopic liver replacement. Hepatogastroenterology 35:316–320, 1988.PubMedGoogle Scholar
  118. 118.
    Iwatsuki S, Gordon RD, Shaw BW, Starzl TE. Role of liver transplantation in cancer therapy. Ann Surg 202:401–407, 1985.PubMedCrossRefGoogle Scholar
  119. 119.
    Koneru B, Cassavilla A, Bowman J, et al. Liver transplantation for malignant tumors. Gastroenterol Clin North Am 17:177–193, 1988.PubMedGoogle Scholar
  120. 120.
    Yokoyama I, Todo S, Iwatsuki S, Starzl TE. Liver transplantation in the treatment of primary liver cancer. Hepatogastroenterology 37:188–193, 1990.PubMedGoogle Scholar
  121. 121.
    Yokoyama I, Sheahan DG, Carr B, et al. Clinicopathologic factors affecting patient survival and tumor recurrence after orthotopic liver transplantation for hepatocellular carcinoma. Transpl Proc 24:2194–2196, 1991.Google Scholar
  122. 122.
    Olthoff KM, Millis JM, Rosove MH, et al. Is liver transplantation justified for the treatment of hepatic malignancies? Arch Surg 125:1261–1268, 1990.PubMedCrossRefGoogle Scholar
  123. 123.
    Jenkins RL, Pinson CW, Stone MD. Experience with transplantation in the treatment of liver cancer. Cancer Chemother Pharmacol 23(Suppl):S104-S109, 1989.PubMedCrossRefGoogle Scholar
  124. 124.
    Margeiter R. Indications for liver transplantation for primary and secondary liver tumor. TransplProc 18(Suppl 3):74–80, 1986.Google Scholar
  125. 125.
    Angrisano L, Jurewicz WA, Clements DG, et al. Liver transplantation for liver cancer. TransplProc 18:1218–1225, 1986.Google Scholar
  126. 126.
    Ismail T, Angrisani L, Gunson BK, et al. Primary hepatic malignancy: The role of liver transplantation. Br J Surg 77:983–987, 1990.Google Scholar
  127. 127.
    Van Thiel DH, Carr B, Iwatsuki S, et al. Liver transplantation for alcoholic liver disease, viral hepatitis, and hepatic neoplasms. Transpl Proc 23:1917–1921, 1991.Google Scholar
  128. 128.
    Iwatsuki S, Todo S, Marsh JW, et al. Treatment of hilar cholangiocarcinoma (Klatskin tumors) with hepatic resection or transplantation. J Am Coll Surg 187:358–364, 1998.PubMedCrossRefGoogle Scholar
  129. 129.
    Langer JC, Langer B, Taylor BR, et al. Carcinoma of the extrahepatic bile ducts: results of an aggressive surgical approach. Surgery 98:752–759, 1985.PubMedGoogle Scholar
  130. 130.
    Lameris JS, Stoker J, Dees J, et al. Non-surgical palliative treatment of patients with malignant biliary obstruction - the place of endoscopic and percutaneous drainage. Clin Radiol 38:603–608, 1987.PubMedCrossRefGoogle Scholar
  131. 131.
    Huibregtse K, Tytgat GN. Palliative treatment of obstructive jaundice by transpapillary introduction of large bore bile duct endoprosthesis. Gut 23:371–375, 1982.PubMedCrossRefGoogle Scholar
  132. 132.
    O’Brien S, Hatfield ARW, Carig PI, Williams SP. A three-year follow-up of self-expanding metal stents in the endosc, opic palliation of long term survivors with malignant biliary obstruction. Gut 36:618–621, 1995PubMedCrossRefGoogle Scholar
  133. 133.
    Shim CS, Lee YH, Cho YD, et al. Preliminary results of a new covered biliary metal stent for malignant biliary obstruction. Endoscopy 30:345–350, 1998.PubMedCrossRefGoogle Scholar
  134. 134.
    Kubota Y, Takaoka M, Kin H, et al. Endoscopic irradiation and parallel arrangement of wallstents for hilar cholangiocarcinoma. Hepatogastroenterology 45:415–419, 1998.PubMedGoogle Scholar
  135. 135.
    Mueller PR, van Sonnenberg E, Ferrucci JT, Jr. Percutaneous biliary drainage: Technical and catheter-related problems in 200 procedures. AJR 138:17–23, 1982.PubMedCrossRefGoogle Scholar
  136. 136.
    Lai ECS, Tompkins RK, Roslyn JJ, et al. Proximal bile duct cancer: Quality of survival. Ann Surg 205:111–118, 1987.PubMedCrossRefGoogle Scholar
  137. 137.
    Malangoni MA, McCoy DM, Richardson JD, Flint LM. Effective palliation of malignant biliary duct obstruction. Ann Surg 201:554–559, 1985.PubMedCrossRefGoogle Scholar
  138. 138.
    Nordaback IH, Pitt HA, Coleman J, Venbrux AC, et al. Unresectable hilar cholangiocarcinoma: Percutaneous versus operative palliation. Surgery 115:597–603, 1994.Google Scholar
  139. 139.
    Guthrie CM, Banting SW, Garden OJ, Carter DC. Segment III cholangiojejunostomy for palliation of malignant hilar obstruction. Br J Surg 81:1639–1641, 1994.PubMedCrossRefGoogle Scholar
  140. 140.
    Farley DR, Weaver AL, Nagorney DM.’Natural history’ of unresected cholangiocarcinoma: Patient outcome after noncurative intervention. Mayo Clin Proc 70:425–429, 1995.PubMedCrossRefGoogle Scholar
  141. 141.
    Oberfield RA, Rossi RL. The role of chemotherapy in the treatment of bile duct cancer. World J Surg 12:105–108, 1988.PubMedCrossRefGoogle Scholar
  142. 142.
    Curley SA, Cameron JL. Hilar bile duct cancer: A diagnostic and therapeutic challenge. Cancer Bull 44:309–315, 1992.Google Scholar
  143. 143.
    Meyers WC, Jones RS. Internal radiation for bile duct cancer. World J Surg 12:99–104, 1988.PubMedCrossRefGoogle Scholar
  144. 144.
    Karani J, Fletcher M, Brinkley D, et al. Internal biliary drainage and local radiotherapy with iridium-192 wire in treatment of hilar cholangiocarcinoma. Clin Radiol 36:603–606, 1985.PubMedCrossRefGoogle Scholar
  145. 145.
    Johnson DW, Safai C, Goffinet DR. Malignant obstructive jaundice: Treatment with external-beam and intracavity radiotherapy. Int J Radiât Biol Phys 11:411–416, 1985.CrossRefGoogle Scholar
  146. 146.
    Mornex F, Ardiet JM, Bret P, et al. Radiotherapy of high bile duct carcinoma using intracatheter iridium 192 wire. Cancer 54:2069–2073, 1984.PubMedCrossRefGoogle Scholar
  147. 147.
    Hishikawa Y, Shimada T, Miura T, et al. Radiation therapy of carcinoma of the extrahepatic bile ducts. Radiology 146:787–789, 1983.PubMedGoogle Scholar
  148. 148.
    Busse PM, Stone MD, Sheldon TA, et al. Intraoperative radiation therapy for biliary tract carcinoma: Results of a 5-year experience. Surgery 105:724–733, 1989.PubMedGoogle Scholar
  149. 149.
    Iwasaki Y, Todoroki T, Fukao K, et al. The role of intraoperative radiation therapy in the treatment of bile duct cancer. World J Surg 12:91–98, 1988.PubMedCrossRefGoogle Scholar
  150. 150.
    Rich TA. Treatment planning for tumors of the gastrointestinal tract. In Paliwal BR, Griem ML (eds). Syllabus: A Categorical Course in Radiation Therapy Treatment Planning. Illinois: RSNA Division of Editorial and Publishing Services, 1986, p. 47.Google Scholar
  151. 151.
    Nunnerly HB. Interventional radiology and internal radiotherapy for bile duct tumors. In Preece PE, Cushieri A, Rosin RD (eds). Cancer of the Bile Ducts and Pancreas. Philadelphia: W.B. Saunders, 1989, p 93.Google Scholar
  152. 152.
    Rich TA. Intraoperative radiotherapy: A review. Radiother Oncol 6:207–221, 1986.CrossRefGoogle Scholar
  153. 153.
    Deziel DJ, Kiel KD, Kramer TS, et al. Intraoperative radiation therapy in biliary tract cancer. Am Surg 54:402–407, 1988.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media Dordrecht 2001

Authors and Affiliations

  • Steven A. Curley
    • 1
  1. 1.The University of Texas M.D. Anderson Cancer CenterHoustonUSA

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