Hilar cholangiocarcinoma

Question 1

Classification

Answer 1

Type I: Tumor below the confluence of the right and left hepatic ducts.

Type II: Tumor involving the confluence.

Type IIIa: Tumor involving the confluence and right hepatic duct.

Type IIIb: Tumor involving the confluence and left hepatic duct.

Type IV: Tumor involving the confluence and both right and left hepatic ducts (multifocal or bilateral involvem

Question 2

Clinical Presentation

Answer 2

Painless progressive jaundice (most common)

Pruritus

Dark urine, pale stools

Weight loss and anorexia

RUQ or epigastric discomfort

Occasionally cholangitis (fever, chills, abdominal pain)

Hepatomegaly or palpable gallbladder

Question 3

Management

Answer 3

A-Unresectable Disease:

1-Palliative biliary drainage (endoscopic or percutaneous stenting)

2-Systemic chemotherapy: Gemcitabine + cisplatin is standard

3-Radiation therapy: For local control or symptom relief

Question 4

Management

Answer 4

Resectable Disease (Types I–IIIb, select IV):

Surgical resection is the only curative option

Question 5

ليها اسم تاني؟

Answer 5

Klatiskin tumour