title: Proximal cholangiocarcinoma: a multidisciplinary approach.
abstract: OBJECTIVE
  To evaluate our diagnosis and treatment of proximal cholangiocarcinoma.
  
  
  METHODS
  Retrospective clinical study.
  
  
  METHODS
  Department of Surgery, University Hospital.
  
  
  METHODS
  66 patients with proximal cholangiocarcinoma [median age (range): 64 years (28-87)].
  
  
  METHODS
  Ultrasonography (n = 65), computed tomography (n = 55), endoscopic retrograde cholangio-pancreaticography [ERCP] (n = 54), percutaneous transhepatic cholangiography [PTC] (n = 32), angiography (n = 19) and cytology (n = 13) were used in diagnosis. Treatment consisted of: insertion of a stent (n = 37), resection of the tumour (n = 16), and biliary-enteric anastomosis (n = 9). Twenty-eight patients received radiotherapy, 3 patients received no active treatment.
  
  
  METHODS
  Usefulness of diagnostic methods, survival.
  
  
  RESULTS
  Ultrasonography, ERCP and PTC were helpful whereas computed tomography, angiography, and cytology added little additional information. Mean (SEM) survival after resection was 35.8 months (7.4) and after conservative treatment 10.4 months (1.5) (p < 0.001).
  
  
  CONCLUSIONS
  A multidisciplinary approach is necessary and the tumour should be resected if possible.
authors.affiliation: Department of Surgery, University Hospital Rotterdam, The Netherlands.
authors.forename: R L
authors.initials: RL
authors.lastname: van der Hul
authors.forename: P W
authors.initials: PW
authors.lastname: Plaisier
authors.forename: J S
authors.initials: JS
authors.lastname: Laméris
authors.forename: B
authors.initials: B
authors.lastname: Veeze-Kuijpers
authors.forename: M
authors.initials: M
authors.lastname: van Blankenstein
authors.forename: O T
authors.initials: OT
authors.lastname: Terpstra
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D001650:Bile Duct Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy*; D001653:Bile Ducts, Intrahepatic; D018281:Cholangiocarcinoma / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy*; D002758:Cholangiography; D002760:Cholangiopancreatography, Endoscopic Retrograde; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed