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Surgical Approach to the Treatment of Cholangiocarcinoma

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Diagnosis and Management of Cholangiocarcinoma

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Abstract

Cholangiocarcinoma is a rare but lethal malignancy arising anywhere along the biliary ductal epithelium from the liver to the duodenum. The disease is classified based on anatomic location, and the mainstay of treatment is surgery. Complete resection is currently the only chance for cure despite significant advances in systemic and other nonsurgical therapies. In this chapter, we present a detailed evaluation of the anatomic classification of cholangiocarcinoma and preoperative evaluation, defining resectability, types of resections, and postoperative outcomes. Special attention is given to advances in the field and the future of surgery in the multidisciplinary management of cholangiocarcinoma.

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Abbreviations

AFP:

Alpha fetoprotein

AJCC:

American Joint Committee on Cancer

BSA:

Body surface area

CCA:

Cholangiocarcinoma

CEA:

Carcinoembryonic antigen

CT:

Computed tomography

dCCA:

distal cholangiocarcinoma

eCCA:

extrahepatic cholangiocarcinoma

ERC:

Endoscopic retrograde cholangiography

FGFR:

Fibroblast growth factor receptor

FLR:

Future liver remnant

GEMOX:

Gemcitabine with oxaliplatin

iCCA:

intrahepatic cholangiocarcinoma

IDH:

Isocitrate dehydrogenase

KGR:

Kinetic growth rate

NCCN:

National Comprehensive Cancer Network

OLT:

Orthotopic liver transplantation

pCCA:

perihilar cholangiocarcinoma

PET:

Positron emission tomography

PVE:

Portal vein embolization

RLV:

Remnant liver volume

SEER:

Surveillance, Epidemiology, and End Results

TFLV:

Total functional liver volume

TLV:

Total liver volume

TNM:

Tumor Node Metastasis

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Authors and Affiliations

  1. Department of Surgery, University of California, Davis, Sacramento, CA, USA

    Sean J. Judge

  2. Department of Radiology, University of California, Davis, Sacramento, CA, USA

    Thomas W. Loehfelm

  3. Division of Surgical Oncology, Department of Surgery, University of California, Davis, Sacramento, CA, USA

    Sepideh Gholami

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  1. Sean J. Judge
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  2. Thomas W. Loehfelm
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  3. Sepideh Gholami
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Correspondence to Sepideh Gholami .

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  1. Division of Gastroenterology, Department of Medicine, Olive View-UCLA Medical Center, Sylmar, CA, USA

    James H. Tabibian

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Judge, S.J., Loehfelm, T.W., Gholami, S. (2021). Surgical Approach to the Treatment of Cholangiocarcinoma. In: Tabibian, J.H. (eds) Diagnosis and Management of Cholangiocarcinoma. Springer, Cham. https://doi.org/10.1007/978-3-030-70936-5_14

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