Cholangiocarcinoma in Sri Lanka :experience of a tertiary referral centre

Cholangiocarcinoma is a malignancy arising from the epithelial lining of the biliary tree, which is associated with a poor outcome. Objectives: to describe the relative incidence of each type of cholangiocarcinoma, it’s gender distribution, common presenting symptoms, the prevalence of metastatic disease and assess the resectability rates. Assess the relationship of different types of cholangiocarcinoma with CA19-9 levels. Methods: A descriptive cross sectional study, of patients diagnosed with cholangiocarcinoma, whose details were obtained from the hepato-pancreato-biliary database that is maintained in a tertiary care unit, in Sri Lanka. Quantitative variables expressed as the mean and standard deviation (SD) and qualitative variables expressed in percentages. The statistical analyses were carried out using SPSS version 25 with statistical significance defined as P<0.05. Results: One hundred and twenty patients were studied. There was a higher incidence of cholangiocarcinoma among males. Average age of presentation was 61.8 years, with males presenting at a slightly older age. Hilar cholnagiocarcinomas were the most common type, followed by distal and intrahepatic. Jaundice was the most common presenting symptom among distal and hilar cholangiocarcinomas. CA 19-9 levels were found to be elevated in 71.9% of the patients. Patients with hilar and intrahepatic cholangiocarcinomas had a higher incidence of advanced disease at the time of presentation with relatively low resectability rates observed among these patients. Discussion: The demographic characteristics and the relative incidence of each type of cholangiocarcinoma was similar to those observed in the western world. However, we noted that the resectability rates in our study to be significantly lower in comparison.