Management Approach of Cholangiocarcinoma of Middle Third Bile Duct

Abstract

Background: Prognosis of middle third cholangiocarcinoma according of recent studies remains poor. However, identifying survival predictors, mentioned a few; stage and patients age, still should take place in clinical practices especially for minor medical facility centers.

Case presentation: A 75 years old lady, was assessed and diagnosed with middle third cholangiocarcinoma, patients underwent from laboratory workup; where SGOT, SGPT were almost threefold elevated, as well Total bilirubin, direct and indirect, were four to tenfold higher than normal levels. CRP as well was seen tenfold higher than normal levels. MRCP was seen dilated of biliary ducts, dilatation of common hepatic duct, narrowing of common hepatic and ductus choledochus that goes with cholangiocarcinoma aspect. Thickness of junction lumen with solid mass 7 mm, infiltrates totally the wall that created the blockage, with increased of contrast intake, no infiltration of pancreas head is seen. Closeness of mass with the vena porta

There were seen two lymph nodes less than 1 cm in gastro hepatic ligament. No infiltration of inferior vena cava, common pancreatic ductus normal. No infiltration of superior mesenteric vena.

After multidisciplinary consultation and patient’s decision informed consent was completed, personalized patients’ treatment was performed, surgical intervention, biopsy and then adjuvant chemotherapy was applied, with a 3-year survival and quality life was achieved.

Conclusions: even in advanced cases of highly malignant cases like cholangiocarcinoma, even most of authors and surgeons agree in low survival rate according to study data, we should create a personalized strategy treatment of each patient in order to increase survival and quality of life as well

Keywords: Cholangiocarcinoma, surgical, chemotherapy, personalized treatment

DOI: 10.7176/ALST/93-06

Publication date: April 30^th 2022