In Reply to: Case 1001-04 -- Occult Klatskin Tumor Causing Ascites, Portal Vein Thrombosis and Weight Loss posted by Editor on October 04, 2001 at 12:05:23:
Moni:
I think that these are difficult cases to handle and I think I would have done something very similar to what you did. I do not think that Klatskin's tumors are curable, however, they can be controlled. I have seen amazing survival times in patients with Klatskin's tumors treated with radiation therapy via percutaneous transhepatic access. These patients however, eventually die with their tumor. The cases that I have been involved with, that were initially managed with ERCP did not fare so good, so we ended up doing them. I usually gain access into right and left ducts and if the anatomy is favorable, use parallel Wallstents, just like you did, but I have never used three access sites.
I usually do this in 2 or three sessions, I find that much easier. Great case. I do not think ascites will get better. My question to you is...did you have any ascites leak through your access sites? and if so, how do you handle that problem?