Author/Editor		Stanisavljevič, Dragan; Mekicar, Jernej
Title		Rak ekstrahepatalnih žolčevodov
Translated title		Extrahepatic bile duct cancer
Type		članek
Source		In: Jelenc F, editor. Zbornik simpozija Kirurgija žolčnika in žolčevodov; 2003 okt; Ljubljana. Ljubljana: Klinični center, Klinični oddelek za abdominalno kirurgijo,
Publication year		2003
Volume		str. 138-42
Language		slo
Abstract		Malignant strictures involving the bile ducts remain a major challenge in biliary surgery. It is an uncommon cancer. The etiology is unknown, most cases are sporadic, but several conditions confer an increased risk of developing cholangiocarcinoma. The early symptoms are nonspecific. In the past computed tomography, percutaneous transhepatic cholangiography and angiography were considered standard investigations, but currently magnetic resonance cholangiopancreatography is providing the same information with less risk. Evaluation of patients is principally an assessment of resectability since resection is the only effective therapy. Bismuth-Corlette classification and determinants of resectability are presented. Different kinds of resections are used, according to the type of tumor based on Bismuth Corlette classification. If resection is not possible, intrahepatic biliary-enteric bypass or percutaneous biliary drainage are performed. Currently there is no role for adjuvant radiochemotherapy. Jucidious use of preoperative investigations and improvements in surgical technique has allowed better patient selection and performance of appropriately radical operations with an acceptable mortality.
Descriptors		BILE DUCT NEOPLASMS BILE DUCTS, EXTRAHEPATIC KLATSKIN'S TUMOR NEOPLASM STAGING