Comprehensive management of cholangiocarcinoma: Part I. Diagnosis

Abstract

A B S T R A C TCholangiocarcinoma is the second most common primary hepatic malignancy and its incidence is increasing worldwide. Classification and staging of intrahepatic, perihilar, and distal cholangiocarcinomas provide useful prognostic information and further guide in their management. Establishing diagnosis is frequently challenging and may require a multi-modality approach that includes advanced radiological imaging studies and procedures for tissue acquisition; the endoscopic procedures that have been utilized in the management of cholangiocarcinoma comprise endoscopic retrograde cholangiopancreatography with brushing and biopsy, endoscopic ultrasound-guided fine needle aspiration, cholangioscopy with targeted biopsy, and intraductal confocal endomicroscopy. In this review, we will examine the strengths and limitations of each diagnostic tool and assess the serum and bile tumor markers.