Multidisciplinary surgery and management for Klatskin’s tumor

The Klatskin cancer is a solid tumor that dilates and blocks the bile ducts causing sclerocutaneo appearance of jaundice. Most forms are sporadic, but sclerosing cholangitis and primary biliary cirrhosis are predisposing factors. Therapy involves surgical resection of the confluence of the biliary tract and the affected portion of the liver associated with locoregional lymphadenectomy. The postoperative complications of these interventions are higher than the conventional ones, so a multidisciplinary approach is needed to minimize perioperative risks. Before the intervention, evaluations are foreseen to exclude contraindications to surgery:

  • Diagnostic laparoscopy, to exclude the presence of the disease outside the biliary tract ;
  • Management of jaundice with possible placement of a biliary drainage, to improve liver function;
  • Assessment of the volume and function of the part of the liver that will remain after the operation, to reduce the risk of liver failure.

Following the operation, the patient will have to undergo chemotherapy and / or radiotherapy to consolidate the results and periodic re-evaluations to rule out relapses.

 

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