Publication

Abstract : Cholangiocarcinoma is a life-threating disease arising from the biliary epithelium and accounts for 10% to 15% of all hepatobiliary malignancies [1]. It is a volume disease involving mostly the common bile duct (CBD), are slow progressing tumour and usually inoperable at presentation. The tumour moves with respiration at a range of up to 1.5-2 cm in superior-inferior direction and hence is a potential candidate for short course ‘real time’ tracking radiation therapy modality [1-2]. Cholangiocarcinomas usually present with obstructive jaundice. ERCP and imaging usually shows a mass in CBD occluding the lumen and resulting in jaundice. Self-retaining metallic stent (SEMS) relieves jaundice for short time, and majority of the patients present with recurrence of fulminant jaundice after few months with fatal outcome [3-4]. Cholangiocarcinomas are locally progressive disease in CBD region and metastasis is a late event. Systemic therapy is not essentially effective in cholangiocarcinoma, mostly because of inherent chemo-resistance and also because patients with compromised liver function do not tolerate chemotherapy. Poor nutritional status and requirement of aggressive surgery with severe morbidity prevent majority of cholangiocarcinoma patients from undergoing surgery.