A translational approach towards perihilar cholangiocarcinoma

Perihilar cholangiocarcinoma (PHC) is a rare tumor that originates in the hilum of the biliary tract. The only curative treatment of PHC is major surgery in which part of the liver and the external bile ducts are resected. This type of surgery comes with a high risk of postoperative complications and death. Therefor it is important that patients are optimally prepared before surgery and that the diagnosis of malignant disease is confirmed (there are other benign diseases that mimic this type of cancer).
In PART I of this thesis one of the major issues in the preoperative preparation of patients with PHC is assessed, namely biliary drainage. In order to safely operate patients with PHC, it is important that bile ducts obstructed by the tumor are drained. There are two methods of biliary drainage that both come with their own set of risks and complications. In order to evaluate this, a randomized controlled trial was executed.
In PART II of the thesis biological behavior and background of not only PHC but also of other biliary tract carcinomas (BTC) are examined. Biliary tract cancers are a family of biologically closely related tumors but are usually considered separately in surgical science, based on anatomical localization.
In PART III of the thesis biological knowledge and molecular data are integrated to develop molecular diagnostic tools that can aid in establishing the diagnosis of PHC.