Perihilar cholangiocarcinoma: what patients should know

It develops where the right and left hepatic ducts meet outside the liver. You may also hear it called a hilar tumour or Klatskin tumour. Its exact position matters because nearby bile ducts, blood vessels and liver tissue influence whether surgery is possible.

A growth at the liver hilum can narrow a bile duct. Bile then builds up, which may cause yellow skin or eyes, dark urine, pale stools, itching, reduced appetite or weight loss. These features can occur with non-cancerous blockage as well, so imaging, blood tests and sometimes tissue sampling are used together.

Doctors assess how far the tumour extends along the ducts and whether it involves major vessels or other organs. They also evaluate liver function and a person's general health. This information guides whether treatment aims to remove the cancer, control it, or relieve obstruction and symptoms.

Seek review by a multidisciplinary hepatobiliary cancer team. Bring imaging discs, scan reports, pathology results, blood-test results and a complete medicine list. The team may need dedicated scans or further sampling before deciding on treatment.

Treatment can include surgery when the tumour can be removed safely, drug therapy, or procedures that drain bile through a stent or catheter. Molecular testing may identify a tumour feature relevant to targeted treatment, although a suitable target is not present in every cancer. Nutrition support and treatment for itching or infection can also be part of care.

Contact the treating team promptly for new or worsening jaundice, increasing itching, vomiting, poor fluid intake or a blocked or leaking drain. Fever or chills with jaundice, confusion, fainting, severe abdominal pain or marked weakness can signal an infected or severely obstructed bile duct and need urgent medical assessment.

Ask where the tumour sits, whether major vessels are involved, what stage has been assigned and whether the case has been reviewed by a hepatobiliary surgeon. Other useful questions cover the goal of each treatment, whether bile drainage is needed, whether molecular testing is appropriate and whom to call if jaundice or fever worsens.