Bile Duct CancerPub Date : 2019-09-25DOI: 10.5772/intechopen.84625
Ahmad Abdullah Madkhali, Faisal Al-alem
{"title":"Distal Cholangiocarcinoma","authors":"Ahmad Abdullah Madkhali, Faisal Al-alem","doi":"10.5772/intechopen.84625","DOIUrl":"https://doi.org/10.5772/intechopen.84625","url":null,"abstract":"Cholangiocarcinoma arises from the epithelial lining of the biliary tree. It accounts for approximately 3% of all gastrointestinal malignancies. This chapter looks at the new advances that have been made in the management of distal cholangiocarcinoma, based on a literature review. Diagnosis of the disease resides mainly in clinical presentation and radiological diagnosis and biopsy indicated in selected cases. Surgical resection is the main curative treatment for distal cholangiocarcinoma, and resectability of the tumor can now be assessed using multiple radiological imaging studies. Resection margins and lymph node invasion status are the two important prognostic factors after surgery. Pancreaticoduodenectomy is the standard surgical treatment of choice in distal cholangiocarcinoma; however, combined major vascular and hepatopancreaticoduodenectomy can be indicated in selected cases. Adjuvant therapy is clearly indicated after surgical resection with survival improvement, but optimal adjuvant treatment strategy has not yet been established.","PeriodicalId":125816,"journal":{"name":"Bile Duct Cancer","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114749723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Bile Duct CancerPub Date : 2019-09-25DOI: 10.5772/intechopen.83655
Gómez-Torres Gustavo Ángel, Hernández-García Fernando Santiago
{"title":"Preoperative Biliary Drainage: Methods, Advantages, and Complications","authors":"Gómez-Torres Gustavo Ángel, Hernández-García Fernando Santiago","doi":"10.5772/intechopen.83655","DOIUrl":"https://doi.org/10.5772/intechopen.83655","url":null,"abstract":"Malignant biliary obstruction is very difficult to treat; only 10–20% of the patients are suitable for curative resections. Obstructive jaundice is associated with a pro-inflammatory state, altering the normal physiology and affecting multiple organ systems. So, patients with malignant obstructive jaundice are at increased risk of postoperative complications. Nevertheless, the preoperative biliary drainage (PBD) remains controversial, because the procedures themselves can be associated with septic and other complications. The main therapeutic options for PBD in malignant biliary obstruction are percutaneous biliary drainage and endoscopic biliary drainage. The knowledge of the approaches, their advantages, and complications are essential for the management of patients with pathologies that produce biliary obstruction such as bile duct cancer. The aim of this chapter is to review the methods for biliary drainage and its indications, advantages, and complications.","PeriodicalId":125816,"journal":{"name":"Bile Duct Cancer","volume":"79 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115330320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Bile Duct CancerPub Date : 2019-09-25DOI: 10.5772/intechopen.84154
N. Bacalbaşa, I. Bălescu, S. Dima, I. Popescu
{"title":"Surgical Advances in the Treatment of Gallbladder Carcinoma at Different Stages","authors":"N. Bacalbaşa, I. Bălescu, S. Dima, I. Popescu","doi":"10.5772/intechopen.84154","DOIUrl":"https://doi.org/10.5772/intechopen.84154","url":null,"abstract":"Gallbladder carcinoma remains the most common cancer originating from the biliary tract, which is associated with poor prognosis and poor survival rates. It is estimated that only one-third of patients with histopathological diagnostic of gallbladder cancer had been correctly diagnosed preoperatively, in the remaining cases the diagnostic being established intraoperatively or postoperatively, based on the histopathological examination. Moreover, although surgery remains the most appropriate therapeutic approach in order to improve survival, it is estimated that only 25% of cases with gallbladder carcinomas present resectable lesions. The cur-rent chapter reviews the most appropriate surgical options in patients diagnosed with both early stage and advanced stage gallbladder cancer, by minimally invasive as well as by open approach. In the meantime, the therapeutic strategies in incidentally diagnosed gallbladder cancer will be discussed.","PeriodicalId":125816,"journal":{"name":"Bile Duct Cancer","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126840953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Bile Duct CancerPub Date : 2019-09-25DOI: 10.5772/intechopen.86175
L. Rodrigo, A. Suárez
{"title":"Introductory Chapter: Bile Duct Cancer","authors":"L. Rodrigo, A. Suárez","doi":"10.5772/intechopen.86175","DOIUrl":"https://doi.org/10.5772/intechopen.86175","url":null,"abstract":"Cholangiocarcinoma (CC) is the most characteristic malignant tumour affecting to the bile ducts. It is a rare neoplasm that originates in the cells of the biliary epithelium. In the USA, it has a mean incidence of 1 case/100,000 inhabitants/year. They are classified into three groups, with respect to their location within the biliary tree: (1) intrahepatic, (2) the upper and middle thirds and (3) the distal part of the common bile duct. Intrahepatic tumours are the least frequent. They behave like primary hepatic tumours. Perihilar, or Klatskin, tumours are the most frequent, accounting for 60–80% of the total. Their incidence increases with age, more cases appearing in patients aged between 50 and 70 years, with a clear predominance in men. The diseases most frequently associated with it are primary sclerosing cholangitis (PSC), choledochal cysts, chronic infections with the parasite Clonorchis sinensis (typical of Asian countries and with a predominant intrahepatic location) and the presence of cholelithiasis and choledocholithiasis. The presence of PSC is an important risk factor, given that it occurs in 30% of cases. In many patients, no known risk factors are found.","PeriodicalId":125816,"journal":{"name":"Bile Duct Cancer","volume":"90 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121487852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Bile Duct CancerPub Date : 2019-05-31DOI: 10.5772/INTECHOPEN.85840
T. Stecca, B. Pauletti, L. Bonariol, E. Caratozzolo, M. Massani
{"title":"Bile Duct Cancer: Preoperative Evaluation and Management","authors":"T. Stecca, B. Pauletti, L. Bonariol, E. Caratozzolo, M. Massani","doi":"10.5772/INTECHOPEN.85840","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.85840","url":null,"abstract":"Cholangiocarcinomas (CCAs) are malignant tumors that can develop anywhere along the biliary tree. Almost 10% of cholangiocarcinomas arise from the intrahepatic bile ducts (iCCA); 50–60% from the bifurcation of the hepatic duct (perhilar cholangiocarcinoma, pCCA); and 20–30% from the distal bile duct (dCCA). The 7th edition of the AJCC staging system, released in 2010, divides the tumors into two major categories: perihilar (pCCA) and distal (dCCA) cholangiocarcinoma, given the differences in anatomy of the bile duct and consideration of local factors related to resectability. There are separate histological classifications for intrahepatic and extrahepatic cholangiocarcinoma. The majority of CCAs (90%) are well or moderately differentiated adenocarcinomas. Other features include invasiveness with early neural, perineural, periductal and lymphatic infiltration (more than 50% of cases at diagnosis) and longitudinal subepithelial infiltration along the wall of the bile duct up to 2 cm proximally and 1 cm distally. In this chapter the extrhepatic bile duct cancers are analyzed.","PeriodicalId":125816,"journal":{"name":"Bile Duct Cancer","volume":"27 5","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"120852498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Bile Duct CancerPub Date : 2019-04-03DOI: 10.5772/INTECHOPEN.85366
A. Bartos, A. Herdean, D. Bartos
{"title":"Surgical Treatment of Distal Common Bile Duct Malignancy","authors":"A. Bartos, A. Herdean, D. Bartos","doi":"10.5772/INTECHOPEN.85366","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.85366","url":null,"abstract":"Distal cholangiocarcinoma is a rare malignant condition arising from the epithelial cells of the biliary tract. Surgical resection is the only curable alternative for patients with this disease. True resectability is often determined by surgical exploration. Duodenopancreatectomy is an extremely high-demanding technique and is the only one that can be potentially curable for patients diagnosed with resectable distal cholangiocarcinoma. Long-term survival may be achieved only in selected patients, undergoing duodenopancreatectomy, especially in patients where R0 margins are achieved. Perineural extension, pancreatic invasion, and lymph nodes involvement are the main risk factors for recurrence. Palliative biliodigestive diver-sion or endoscopic internal drainage of the biliary tree is alternative for patients with unresectable tumors. Although the prognosis after surgical treatment of distal common bile duct malignancy is better than for other periampullary tumors, the continuous progresses made in the field of surgical therapy and oncological treatment may lead to an improvement in the outcome of this neoplastic pathology.","PeriodicalId":125816,"journal":{"name":"Bile Duct Cancer","volume":"152 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132162089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Bile Duct CancerPub Date : 2018-11-22DOI: 10.5772/INTECHOPEN.82113
P. Prasoon, K. Miura, K. Yuza, Y. Hirose, J. Sakata, T. Wakai
{"title":"Perihilar or (Hilar) Cholangiocarcinoma: Interventional to Surgical Management","authors":"P. Prasoon, K. Miura, K. Yuza, Y. Hirose, J. Sakata, T. Wakai","doi":"10.5772/INTECHOPEN.82113","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.82113","url":null,"abstract":"Peri-hilar cholangiocarcinoma (PHC) or hilar cholangiocarcinoma (HCCA) characterizes a critical effort to assess significantly sick patients. The existing scenery and proof to the diagnosis and treatments for hilar cholangiocarcinoma are improving day by day. Patients with HCCA encounter numerous obstacles in acquiring efficient therapies. The condition is uncommon, and the majority patients don’t have any distinct risk factors, doing selection process inadequate. The initial signs and symptoms in many cases are non-specific, and in many patients the tumors are not resectable because of involvement of the perihilar structures. MRI with MRCP offers further information about the extent of biliary involvement. Furthermore, endoscopic stenting and percutaneous drain could be useful for intricate hilar strictures. Surgical resections with negative margins are related to good likelihood of survival for patients representing with HCCA. Regardless of the accessibility of curative treatment strategies such as operative resection and liver transplantation, most sufferers with HCCA shows with repeated, metastases or locally advanced disease with a poor prognosis. Within this chapter, we have tried to elaborate the modalities of treatment from intervention to surgical approach for HCCA.","PeriodicalId":125816,"journal":{"name":"Bile Duct Cancer","volume":"40 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115698622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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