What is a Klatskin tumor?
Klatskin tumor is a special type of bile duct carcinoma (cholangiocellular carcinoma), a cancer of the bile ducts. It is located at the so-called hepatic fork, where the left and right hepatic ducts join to form the common hepatic duct. That’s why doctors also call it bifurcation carcinoma or carcinoma of the hepatic fork. Most people are between 60 and 70 years old when they are diagnosed with a Klatskin tumor.
Prognosis: What are the chances of cure for Klatskin tumor?
The overall prognosis for Klatskin tumor is poor. When the doctor diagnoses the bile duct tumor, it is often no longer possible to operate on it. This is because it has usually already grown considerably by the time the affected person notices the first symptoms. Life expectancy with Klatskin tumor is therefore very low. Five years after diagnosis, less than five percent of those affected are still alive.
What are the symptoms of Klatskin tumor?
Often, people with a Klatskin tumor do not notice their disease at first. Only when the cancer is already in an advanced stage and the tumor grows larger do symptoms appear. The most important symptom is jaundice (icterus). In addition, there is sometimes pain in the abdominal area, severe weight loss and general malaise.
The cause of Klatskin tumor is not precisely known. Among the risk factors known to date that favor the development of a Klatskin tumor are gallstones located in the liver and the so-called Caroli syndrome. In Caroli syndrome, the bile ducts of affected individuals are dilated.
Other diseases that cause chronic biliary inflammation are also considered risk factors. These include primary sclerosing cholangitis (an inflammatory disease of the bile ducts) or parasitic diseases (for example liver fluke).
What is the examination and diagnosis process?
Just as with cholangiocellular carcinomas located elsewhere in the bile ducts, doctors use a variety of examination methods to diagnose a Klatskin tumor. These include taking a blood sample and testing the blood for altered liver and bile levels. The doctor often does an ultrasound examination of the abdomen (abdominal ultrasonography).
In addition, the bile ducts can be visualized with the help of contrast medium in an X-ray and possible constrictions of the bile ducts caused by tumors, such as a Klatskin tumor, can be detected. In addition, other imaging techniques are used in the diagnosis of Klatskin tumor, in particular magnetic resonance imaging (MRI) and computed tomography (CT).
If surgery is still possible, the surgeon removes the tumor along with the common hepatic duct, hepatic fork, and left and right hepatic ducts. If necessary, the surgeon also removes parts of the liver.
If it is no longer possible to surgically remove the Klatskin tumor, the doctor begins palliative treatment. “Palliative” means that the affected person receives therapy that alleviates the symptoms as best as possible, even if it is no longer curable. To ensure that the bile flows out despite the Klatskin tumor, a surgeon inserts so-called stents into the bile ducts. These are small tubes that keep the bile ducts open.
