title: Endoscopic management of hilar cholangiocarcinoma.
abstract: Hilar cholangiocarcinoma has a poor prognosis and surgery remains the only curative option. However, few patients are diagnosed at a curable stage and palliative therapies are, therefore, mandatory. Endoscopy could have a useful role in the work-up of patients with hilar cholangiocarcinoma who are unsuitable for surgery. Endoscopic retrograde cholangiopancreatography provides an opportunity to collect specimens for cytological or histological diagnosis, yet is often nondiagnostic. Other techniques, including fluorescence in situ hybridization, confocal laser endomicroscopy and endoscopic ultrasonography, are now improving the accuracy of tissue diagnosis. This Review presents an overview of the diagnostic and therapeutic role of endoscopic procedures in the management of hilar cholangiocarcinoma. The use of such procedures in guiding the therapeutic management of patients with hilar cholangiocarcinoma is discussed, and the relative success of endoscopic stenting as the main palliative therapy for obstructive jaundice (a common complication of hilar cholangiocarcinoma) is described. The potential role of photodynamic therapy as a palliative treatment for patients with hilar cholangiocarcinoma is also outlined.
authors.affiliation: Department of Gastroenterology, General Hospital of Sanremo, Via Borea 56, Sanremo 18038, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Parodi
authors.forename: Deborah
authors.initials: D
authors.lastname: Fisher
authors.forename: Marc
authors.initials: M
authors.lastname: Giovannini
authors.forename: Todd
authors.initials: T
authors.lastname: Baron
authors.forename: Massimo
authors.initials: M
authors.lastname: Conio
mesh_terms: D001650:Bile Duct Neoplasms / Q000175:diagnosis / Q000601:surgery*; D001653:Bile Ducts, Intrahepatic; D018281:Cholangiocarcinoma / Q000175:diagnosis / Q000601:surgery*; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000379:methods; D019468:Disease Management; D004724:Endoscopy / Q000379:methods*; D019160:Endosonography; D006801:Humans