Tumor de Klatskin: diagnóstico, evaluación preoperatoria y consideraciones Es un tumor agresivo con una resecabilidad al diagnóstico del 47% y una. Cholangiocarcinomas (CCCs) are malignancies of the biliary duct system Perihilar tumors, also called Klatskin tumors (after Klatskin’s description of them in The etiology of most bile duct cancers remains undetermined. Klatskin tumor is an extra-hepatic cholangiocarcinoma (CCA, see this term) arising in the junction of the main right or left hepatic ducts to form the common.
|Published (Last):||14 June 2009|
|PDF File Size:||15.2 Mb|
|ePub File Size:||7.21 Mb|
|Price:||Free* [*Free Regsitration Required]|
Despite the lack of any apparent benefit, the overall poor prognosis for Klatskin tumors supports continued clinical investigations in the use of adjuvant therapy in both resectable and unresectable patients. Romanian Journal of Internal Medicine. Levels of the tumor markers carbohydrate antigen CAcarcinoembryonic antigen CEA and CA are abnormally high in the bloodstreams of patients with intrahepatic cholangiocarcinoma and Klatskin tumor.
Clear Turn Off Turn On. More recently, the routine use of staging laparoscopy prior to laparotomy has been suggested in order to minimally cancef assess patients for evidence of liver metastases or peritoneal implants.
Klatskin tumor – Wikipedia
Nat Rev Gastroenterol Hepatol, 8pp. The use of biliary catheters in patients with Klatskin tumors is somewhat controversial. The malignant stricture can be dilated to place a progressively larger silastic catheters into dee right and left ductal systems.
Van Gulik et al. The disease was named after Gerald Klatskin, who in described 15 cases and found some dw for this type of cholangiocarcinoma   . Clinical diagnosis and staging klatskni cholangiocarcinoma. Complex epithelial Warthin’s tumor Thymoma Bartholin gland carcinoma.
Diagnostic methods Diagnosis is suspected on clinical and laboratory findings. Serous microcystic adenoma Intraductal papillary mucinous neoplasm Mucinous cystic neoplasm Solid pseudopapillary neoplasm Pancreatoblastoma. Further, industrial exposure to asbestos and nitrosaminesand the use of the radiologic contrast agent, Thorotrast thorium dioxideare considered to be risk factors for the development of cholangiocarcinoma.
Lobular carcinoma in situ Invasive lobular carcinoma. To reduce the morbidity associated with infections following preoperative biliary drainage, it is suggested that the bile be systematically cultured following drainage and during surgery.
Epithelium canxer epithelial tissue.
They have now been replaced in diagnosis by MR-cholangiography. Due to all of the above considerations it is recommended that each case be evaluated individually, and that surgery be used if an R0 resection can be achieved in the absence of distant metastasis or peritoneal involvement. The group without preoperative drainage non-PBD was composed of patients, and the group with biliary drainage PBD contained patients.
Br J Surg,pp. Treatment of hilar cholangiocarcinoma Klatskin tumors with hepatic resection or transplantation. After biliary ductal demonstration has been demonstrated by imaging studies, it is imperative for proximal biliary tumors that cholangiography be performed.
Klatskin tumors – Surgical Treatment – NCBI Bookshelf
Other search option s Alphabetical list. Radical en-bloc resection and vascular reconstruction is the technique which has achieved the highest rate of survival in the long term. Clinical description Klatskin tumors occur in the hepatic duct bifurcation, usually presenting in the 5th to 7th decade of life and are seen slightly more frequently in males 1.
Cholangiography should define not only the location, but also visualize the uppermost extent of the tumor to determine the limits of resectability. Differential diagnosis Autoimmune cholangitis and primary biliary non-Hodgkin’s lymphoma are differential diagnoses of Klatskin tumors. The association between cholangiocarcinoma and hereditary nonpolyposis colorectal carcinoma. CS1 Spanish-language sources es CS1 Italian-language sources it CS1 German-language sources de Articles lacking in-text citations from August All articles lacking in-text citations Infobox medical condition All articles with unsourced statements Articles with unsourced statements from August Dig Dis Sci, 58pp.
They are usually highly developed tumours with locoregional vascular and lymph node invasion. Turn recording back on.
Diagnosis, Preoperative Evaluation and Surgical Considerations. With the improved diagnostic tests and histopathological knowledge, in the future we klatski be better able to define whether they are 2 distinct entities or if they are clinically and biologically the same. Complete resection of the tumor, especially in early-stage disease, offers hope of long-term survival.
Resectability is further assessed at operation by careful exploration for peritoneal implants, hepatic metastasis and regional lymph node involvement. With the improved diagnostic tests and histopathological knowledge, in the future we may be better able to define whether they are 2 distinct entities or if they are clinically and biologically the same.
This classification aims to predict the resectability of tumours, taking 3 local extension factors into account.
However, a tissue diagnosis is important to differentiate a stricture due to primary sclerosing cholangitis from hilar cholangiocarcinoma in patients who might otherwise be candidates for liver transplantation. Surg Gynecol Obstet ; Primary peritoneal carcinoma Peritoneal mesothelioma Desmoplastic small round cell tumor.
The standard operative approach at the Johns Hopkins Hospital for bifurcation tumors is limited resection to the hepatic duct bifurcation with reconstruction as a bilateral hepaticojejunostomy with the routine use of transhepatic silastic stents. There is also the possibility of accepting book reviews of recent publications related to General and Digestive Surgery. Gastroenterol Clin Biol ; The majority of studies have evaluated these in pancreatic neoplasias and in CC to a lesser extent, without specifying their location or characteristics.
The documents contained in this dde site are presented for information purposes only. Brush cytology and percutaneous biopsies have a low sensitivity for diagnosis. Preoperative biliary drainage for hilar cholangiocarcinoma: Renal cell carcinoma Endometrioid tumor Renal oncocytoma. Systematic review and meta-analysis of the role of vascular resection in the treatment of hilar cholangiocarcinoma.
A choleduojejunostomy to a Roux-en-Y jejunal limb is completed.