Extrahepatic Cholangiocarcinoma Diagnosis and Therapeutic Management

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Introduction: Extrahepatic cholangiocarcinoma is a rare and severe cancer, representing less than 3% of malignant digestive neoplasms and is the second most common primary liver cancer after hepatocellular carcinoma (HCC). Its frequency is often underestimated. The resectability rate depends on the tumor's location (5-30% in hilar forms). Objective: Evaluate the surgical treatment outcomes of extrahepatic cholangiocarcinoma. Patients and Methods: This retrospective, single-center, and analytical study spanned from January 1, 2018, to September 30, 2023, involving 20 patients (excluding Klatskin tumors). The mean patient age was 65 years (range: 55-74), with a male-to-female ratio of 2.3. Most patients were classified as ASA I and II (American Society of Anesthesiologists). Results: Clinically, jaundice was observed in 100% of cases. Nine patients exhibited general health deterioration. The diagnostic delay averaged 9 months (range: 9-18 months). Histologically, adenocarcinoma was identified in 100% of surgical specimens. Surgery was performed in 40% of patients, while palliative care was applied in 45%. Post-resection morbidity was 35%, and mortality was 37.5%. Conclusion: Surgical resection remains the only treatment offering prolonged survival, though five-year survival rates are low, even after curative procedures.