In these tumors it may be difficult to get a definitive diagnosis pre-operatively.
Biopsy is almost impossible and results of endoscopic brushing are commonly negative.
The staging is done with cholangiography and is based on the finding of mass effect (shouldering), irregular margins and abrupt tapering at the obstruction.
The limitations of MRCP in staging are the spatial resolution and the inability in the evaluation of the secondary ducts.
ERCP is superior to MRCP (figure)
Biopsy is almost impossible and results of endoscopic brushing are commonly negative.
The staging is done with cholangiography and is based on the finding of mass effect (shouldering), irregular margins and abrupt tapering at the obstruction.
The limitations of MRCP in staging are the spatial resolution and the inability in the evaluation of the secondary ducts.
ERCP is superior to MRCP (figure)
 |
| Hilar Cholagiocarcinoma. Notice the superiority of ERCP to MRCP. The image on the right nicely demonstrates the shouldering at the hilum and the multiple strictures. |
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