Biliary

Question 1

Histologic types of intrahepatic cholangioca?

Answer 1

1. Mass forming
2. Periductal infiltrating
3. Intra-ductal

Question 2

ICC prognostic factors?

Answer 2

Node positivity
Number of tumors (not size)
Vascular invasion

Question 3

Cholangiocarcinoma adjuvant therapy?

Answer 3

Cape for 6 months (BILCAP)

Question 4

Chemotherapy for advanced ICC?

Answer 4

Gem/Cis (ABC-02)

Question 5

Extrahepatic cholangio morphologic types?

Answer 5

• Sclerosing ( 70 %, no mass, strictures, worst outcome)
• Nodular (20%), some mass, strictures
• Papillary (10%, intraluminal, no stricture, best outcome)

Question 6

ICC Caudate lobe reasons for resection?

Answer 6

• Involved in 35 %
• Borders between liver and caudate unclear
• Caudate recurrence high

Question 7

Mayo protocol hilar cholangio?

Answer 7

5-FU + EBRT
Brachy boost
Maintenance Cape
Transplant after

Question 8

Gall bladder adeno T stage?

Answer 8

T1a- Mucosa
T1b- Muscularis
T2a- Peritoneal side serosa
T2b- hepatic side invasion
T1b and above radical chole

Question 9

ICC imaging findings?

Answer 9

Arterial enhancement without venous washout
Capsular retraction when present pathognomonic

Question 10

ICC minimum lymph nodes?

Answer 10

6

Question 11

Hilar cholangio indications for PBD?

Answer 11

• If FLR <30% drainage reduces hepatic failure
• If PVE required
• Cholangitis
• If receiving neoadjuvant chemo
• Severe malnutrition