Cholangiocarcinoma Surgery Dhaka

• Intrahepatic cholangiocarcinoma (iCCA) — within the liver; managed by hepatectomy with regional lymphadenectomy
• Hilar (perihilar) cholangiocarcinoma — Klatskin tumour at the bile-duct confluence; the most common and most complex
• Distal cholangiocarcinoma — lower bile duct; managed by Whipple procedure

Workup includes high-resolution MRCP, triple-phase CT for vascular involvement, CA 19-9, and (when needed) endoscopic ultrasound with biopsy. For Klatskin tumours, the Bismuth–Corlette classification guides the resection plan. Pre-operative biliary drainage (PTBD or ERCP stenting) is selectively used to lower bilirubin before major hepatectomy. Portal vein embolisation may be needed to grow a small future liver remnant.

Curative surgery for hilar cholangiocarcinoma typically involves extended right or left hepatectomy with caudate lobectomy, en-bloc bile-duct resection, regional lymphadenectomy, and Roux-en-Y hepaticojejunostomy. Vascular reconstruction (portal vein resection) is occasionally required. The operation typically takes 6–10 hours. Dr. Arefin's team includes specialist anaesthetists and an experienced ICU — essential for safe major hepatectomy.

5-year survival after R0 resection is 25–40% for Klatskin tumours and up to 50% for distal lesions. Adjuvant capecitabine chemotherapy is now the global standard after resection (BILCAP trial) and is coordinated with medical oncology. Lifelong surveillance with imaging and CA 19-9 every 3–6 months is essential. Book a consultation for a personalised plan.