Pervaya respublikanskaya klinicheskaya bol'nica
Russian Federation
Gorodskaya klinicheskaya bol'nica №2
Klatskin tumor is a rare and aggressive malignant neoplasm that is difficult to diagnose in its early stages due to overlapping symptoms with other biliary tract diseases. Modern imaging methods, including ultrasound, CT, and MRI, significantly improve diagnostic accuracy. However, diagnostic delays are still observed in clinical practice, which often leads to serious complications such as acute biliary pancreatitis, cholangitis, sepsis, and multiple organ failure. Delays in diagnosis or initiation of treatment worsen the prognosis for patients, underscoring the need for improved approaches to early diagnosis, comprehensive examination, and better treatment strategies. To assess the challenges of diagnosing and treating Klatskin tumor in a multidisciplinary hospital setting based on clinical cases of patients with obstructive jaundice. Two clinical cases of patients with Klatskin tumor are presented. Diagnostic challenges and treatment strategies at various stages of the disease are described. Results. In all cases, patients presented with symptoms of obstructive jaundice, which complicated early diagnosis. Delays in accurate diagnosis led to disease progression and complications, including pancreonecrosis and multiple organ failure. Surgical tactics included percutaneous biliary drainage, but radical operations were hindered by the advanced stage of the tumor. The treatment was primarily palliative. Early diagnosis and timely surgical correction of bile duct obstruction significantly improve the prognosis for patients with Klatskin tumor. Diagnostic errors and treatment delays increase the risk of complications and mortality, highlighting the need for strict adherence to clinical guidelines.
Klatskin tumor, obstructive jaundice, diagnosis, multidisciplinary hospital, differential diagnosis, etiology.
1. Turlak A. S., Kozlov A. V., Tarazov P. G., Polikarpov A. A., Popov S. A., Granov D. A. Klatskin tumor: diagnostic challenges and preoperative staging. Observation from practice. Oncological Journal: Radiation Diagnostics,
2. Prokhorov A. V., Papok V. E. Klatskin tumor: educational manual. Minsk: BSMU; 2015. (In Russ.).
3. Dedov A. V., Mustafin R. D., Polukhina E. A. On the difficulties of diagnosing and complications of Klatskin tumor. Astrakhan Medical Journal. 2023;18(2):110-119. (In Russ.). doihttps://doi.org/10.29039/19926499-2023-2-110-119.
4. Styazhkina S. N., Bikbulatova V. V., Golovkina S. A., Kamaletdinova K. M., Zaitsev D. V., Sharafutdinov M. R., Antropova Z. A. Modern methods of diagnosis and treatment of focal liver lesions. Current Problems of Modern
5. Styazhkina S. N., Ayubov R. K., Takhirov Sh. U., Semenov A.S. Hemihepatectomy as an effective method for treating malignant liver neoplasms. Science Diary. 2024;1(85).
6. Alieva S. B., Bazin I. S., Breder V. V., et al. Cancer of the biliary system. Clinical Guidelines. Moscow, 2020. (In Russ.). URL: https://oncologyassociation.ru/wp-content/uploads/2020/09/ biliarnyj_rak.pdf. (Accessed November 5,
7. Tarazov P. G., Kagacheva T. I. X-ray endovascular interventions in the treatment of intrahepatic cholangiocarcinoma (literature review). Diagnostic and Interventional Radiology. 2021;15(3):55-66. (In Russ.).
8. Galperin E. I., Vetshev P. S. Guide to surgery of the bile ducts. Moscow: Vidar-M Publishing House, 2006. (In Russ.).
9. Efanov M. G., Alikhanov R. B., Tsvirkun V. V., Melekhina O. V., Kim P. P., Kazakov I. V., Vankovich A. N., Byakhov M. Yu. The first results of radical and conditionally radical resections for Klatskin tumor. Malignant Tumors.
10. Frantsev D. Yu., Sergeeva O. N., Dolgushin B. I. Treatment of hilar cholangiocarcinoma. Current status of the issue. Siberian Oncological Journal. 2019;18(1):103-115. (In Russ.). doihttps://doi.org/10.21294/18144861-2019-18-1-103-115.
