In Reply to: Re: Case 1001-04 -- Occult Klatskin Tumor Causing Ascites, Portal Vein Thrombosis and Weight Loss posted by Hector Ferral on October 08, 2001 at 10:17:53:
Moni - I'm surprised you didn't attempt to
recanalize the portal vein to relieve the ascites.
Our transplant team here has transplanted a
number of young cholangiocarcinoma
patients after aggressive chemo/radiation,
with reasonable mid-term results, but even
transplant is not considered a cure.
We typically do these procedures in at least
two settings, to minimize the risk of sepsis
from the obstructed bile. For true Klatskin
bifurcation lesions, I have been using Smart
stents, which can be manipulated into forming
a Y-shaped bifurcated stent. I don't know if the
patency is any better, but it looks cool. I hate it
when our GI people put Wallstents in from
below because they almost always jail off
branches that then become our problem.