Learn about how this type of bile duct cancer is diagnosed and treated.
Hilar cholangiocarcinoma is a type of bile duct cancer that occurs in the bile ducts that lead out of the liver (hepatic ducts) and join with the gallbladder. Hilar cholangiocarcinomas are also known as Klatskin tumors.
The gallbladder serves as a reservoir for a yellow-green fluid produced in the liver, called bile. Bile flows from the liver into the gallbladder, where it's held until needed during the digestion of food. When you eat, the gallbladder releases bile into the bile duct. It's then carried to the upper part of the small intestine, called the duodenum, to help break down fat in food.
Tests and procedures used to diagnose hilar cholangiocarcinoma include:
Biopsy using endoscopic retrograde cholangiopancreatography (ERCP) or endoscopic ultrasound and specialized lab testing with fluorescence in situ hybridization (FISH)
Doctors typically don't recommend collecting cells using a needle inserted through your skin and into your bile duct (transperitoneal biopsy). This technique increases the risk of cancer recurrence and may make you ineligible for a liver transplant.
Which treatment is best for you will depend on the location and extent of your hilar cholangiocarcinoma. Treatment typically involves surgery, liver transplant or supportive treatments to reduce your pain and other symptoms.
Surgery for hilar cholangiocarcinoma involves removing:
The surgeon then connects the remaining bile ducts to the small intestine so that bile can still reach your digestive tract and help digest food.
Some people with early-stage hilar cholangiocarcinoma may consider liver transplant. Chemotherapy and radiation are typically used before the liver transplant to kill as many cancer cells as possible before surgery.
This treatment typically involves:
You may undergo routine tests to evaluate your health while waiting for a liver transplant to make sure you're healthy enough for the surgery.
People with advanced hilar cholangiocarcinoma who aren't able to undergo surgery or liver transplant may receive chemotherapy to slow the growth of the cancer.