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Early detection and treatment of cholangiocarcinoma
Author(s) -
Gores Gregory J.
Publication year - 2000
Publication title -
liver transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.814
H-Index - 150
eISSN - 1527-6473
pISSN - 1527-6465
DOI - 10.1053/jlts.2000.18688
Subject(s) - medicine , liver transplantation , primary sclerosing cholangitis , exploratory laparotomy , malignancy , radiology , stage (stratigraphy) , laparotomy , positron emission tomography , intrahepatic cholangiocarcinoma , gastroenterology , transplantation , surgery , paleontology , disease , biology
Key Points 1. The major identified risk factor for the development of cholangiocarcinoma in Western countries is primary sclerosing cholangitis (PSC). 2. The diagnosis of cholangiocarcinoma in PSC requires a high index of suspicion because endoscopic brush cytology and/or biopsies and imaging studies are often negative for malignancy. Positron emission tomography is a promising imaging modality for the diagnosis of cholangiocarcinoma, even in patients with PSC. 3. A serum carbohydrate antigen 19‐9 value greater than 100 U/mL has a sensitivity and specificity for cholangiocarcinoma of approximately 75% and 80%, respectively. 4. Liver transplantation is a viable therapeutic option for selected patients with early‐stage cholangiocarcinoma. Outcomes are optimized by using preoperative radiation and chemotherapy and ensuring the absence of metastases by an exploratory laparotomy.