ABSTRACT
Ronald S. Chamberlain, Leslie H. Blumgart Cholangiocarcinoma is an uncommon malignancy with an incidence of
1.2/100,000. This neoplasm accounts for less than 2% of all cancer diagnoses with equal sex distribution. The incidence of cholangiocarcinoma increases with age, with two-thirds of all cases occurring in patients over 65. Jaundice is the presenting com plaint in 90-98% of patients with cholangiocarcinoma. Additional complaints include weight loss (29%), abdominal pain (20%), and occasionally fever (9%). Jaundice may be absent if the tumor is intrahepatic or involves only the right or left hepatic duct. In these cases, the resultant lobar obstruction leads to ipsilateral hepatic lobar atrophy whose only manifestation may be an elevated alkaline phosphatase. Despite a high incidence of bactobilia in patients with both complete and incomplete ob struction due to cholangiocarcinoma, cholangitis is a rare presentation. However, a two-fold increase in postoperative infectious complications has been reported in association with preoperative instrumentation and stenting.
