HPB Surgery › Cholangiocarcinoma
Cholangiocarcinoma
Specialist surgical care for bile duct cancer, including Klatskin tumours, perihilar and distal cholangiocarcinoma.
Overview
Cholangiocarcinoma (Bile Duct Cancer)
Cholangiocarcinoma is a cancer arising from the bile duct epithelium. It can occur at various locations along the biliary tree and is classified as intrahepatic, perihilar (Klatskin tumour), or distal cholangiocarcinoma. Surgical resection is the only potentially curative treatment and requires specialist HPB surgical expertise.
Complex Surgery Required
Cholangiocarcinoma surgery is technically demanding and should be performed at a specialist HPB centre. Treatment often involves major liver resection combined with biliary reconstruction.
Types of Cholangiocarcinoma
- Intrahepatic cholangiocarcinoma — arises within the liver parenchyma
- Perihilar cholangiocarcinoma (Klatskin tumour) — at the confluence of left and right bile ducts
- Distal cholangiocarcinoma — in the distal bile duct (treated by Whipple's procedure)
Symptoms
- Obstructive jaundice (yellow skin and eyes)
- Dark urine and pale stools
- Itching (pruritus)
- Abdominal pain
- Unexplained weight loss
- Fever (if cholangitis develops)
Surgical Treatment
Surgical resection for cholangiocarcinoma typically involves major liver resection combined with resection of the extrahepatic bile duct and reconstruction with a hepaticojejunostomy (Roux-en-Y biliary-enteric anastomosis). Pre-operative portal vein embolisation may be required to increase the volume of the liver remnant prior to major resection. Dr. Nahm has extensive experience in these complex procedures through his HPB and transplant fellowships in Australia and the UK.