Información del artículo
Resumen
Los colangiocarcinomas hiliares son neoplasias poco frecuentes que, por su localización anatómica, plantean importantes dificultades técnicas en la resección quirúrgica. La supervivencia a largo plazo sólo se consigue en los casos resecados, por lo que es importante la identificación de los pacientes que presentan factores de riesgo, así como el diagnóstico precoz y la valoración de la resecabilidad por un cirujano experimentado en cirugía hepatobiliar. En este trabajo se pretende dar una visión de conjunto del colangiocarcinoma hiliar, que abarca los factores de riesgo, el diagnóstico (las pruebas de laboratorio, las técnicas de diagnóstico por imagen, la anatomía patológica) y las distintas modalidades de tratamiento, especialmente la resección quirúrgica. Se comparan las tasas de resecabilidad y la supervivencia a largo plazo tras la resección con intención curativa en las series más relevantes de la bibliografía. Asimismo, se exponen las modalidades de tratamiento paliativo quirúrgico y radiológico en los casos irresecables y las terapias adyuvantes utilizadas por los diferentes autores.
Palabras clave:
Colangiocarcinoma hiliar
Neoplasias
Tratamiento
Tumor de Klatskin
Hilar cholangiocarcinomas are rare neoplasms. Due to their anatomical location, surgical resection is technically difficult. Long-term survival is only achieved in patients who have undergone resection. Consequently, identification of patients with risk factors, early diagnosis and evaluation of resectability by a surgeon with experience in hepatobiliary surgery are essential. The aim of this study was to provide an overall view of hilar cholangiocarcinoma, including its risk factors, diagnosis (laboratory investigations, diagnostic imaging techniques, pathologic anatomy) and the various treatment modalities, especially surgical resection. We compare resectability and longterm survival rates after curative resection in the most important series reported in the literate. In addition, the treatment modalities used in palliative surgery and radiological treatment in non-resectable cases, as well as the adjuvant therapies used by different authors, are discussed.
Key words:
Hilar cholangiocarcinoma
Neoplasias
Treatment
Klatskin’s tumor
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