Klatskin Tumor
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I would ask the Surgeon. I remember before Teddy’s Whipple the Surgeon sat with us and drew a sketch of what was going to take place. I asked him to sign it so I could frame it! Of course I was only joking but it brought all a good laugh. You might Google the name of the surgery and see if any pictures pop up. I am sure the Surgeon has ‘something’ on it.
Thanks to both of you and I am sure that I’ll turn to you all again after we see the Dr tomorrow to discuss the surgery in detail.
It would be great to have a good graphic of the liver, veins, arteries, and ducts. Any recommendations?
Oh, Fred, what outstanding news to wake up to this morning! We LOVE the word surgery! The only hint I can give you is, I had another type of cancer removed from my colon 6 years ago and on the table just before they put me to sleep I asked for an Epidural and they said sure. This froze the whole abdominal area for almost 2 days. I always suggest it and would do it again. And, the longer the surgery takes do not get upset as that means things are a good go and this surgery does take hours. Like Pat said your son has youth on his side. These surgeries are big but not life threatening like the heart. I am so excited for your son and family! Prayers, good thoughts and vibes headed your way.
Fred, every cancer case is different in some way, the only thing that is always the same is that we call it cancer. That said I will share some things I remember leading up to my surgery. I remember being more excited than fearful about the operation, The surgeon explained to me the importance of the portal veins involvement with the tumor. My tumor was contained in the left hepatic duct and had not “grown through” the sides of the bile duct yet. the hepatic vein runs along the bile duct where it enters the liver about the same area the bile ducts come out. It is easy for this to turn into a big mass which is difficult to dissect and separate healthy from sick cells. I asked why remove half the liver if a tumor is in my bile duct? After my surgery he explained cancer is present in the bilary tree within the liver like rust on the inside of steel pipes, hard to show me on a ct scan but seeing as there is a tumor further down the duct, it is presumed the liver is also involved, curative surgery requires removal of all possibly involved tissue. That means half the liver or more. Be positive, he’s young, you found it earlier than most, pray, many prayed for me, it can’t hurt. Try to help him find ways to relax, 10 minutes of quiet solitude a day, It sounds like his chances are good for a positive outcome, best wishes to both of you, Pat
Good news- and thanks to all in these discussions for sharing your knowledge.
After moving our son to UT Southwest in Dallas to get a second opinion from a surgical oncologist, we were just informed that his surgery to attempt to remove his Klatskin tumor is scheduled for next month.
As we reviewed his MRIs and CTs, the decision was made based on the tumors size and location and impact on the left portal vein and left hepatic duct. Surprisingly, his left hepatic artery appears good. So it appears that only the left lobe has been impacted by the tumor.
He also cautioned that, even after operating, the tumor can be removed in only 50% of the cases. A bit surprising to us.
Would you have any guidance as we approach his surgery?
Thanks
FredRoux-en-Y (Hepaticojejunostomy) is actually what they do after the resection of the tumor, common bile duct, gall bladder, and part of the liver to “re-plumb” the area so that the bile from the liver continues to flow into the intestine.
dhometexas wrote:And a bit more- I have read that a Roux-en-Y is a surgery that would be used to remove a Klatskin tumor. Is this the case?You may also want to take a look at the surgery link on our site:
http://cholangiocarcinoma.org/the-disease/treatment-options/dhometexas…….this is what I have learned: the upcoming test results will clarify that chemo and radiation achieved shrinkage of the tumor allowing for a resection. Criteria for resection include “location” of tumor i.e. vicinity to a major artery, size, or metastases and other reasons. I am a bit puzzled about your question re: liver transplantation. Had this been mentioned? A select group of hilar (perhilar) patients are eligible for transplantation if criteria is met. Where is your son receiving his current treatments?
The American Association for the Study of Liver disease Guidelines recommends that potential transplant candidates should be expeditiously referred to major cancer centers that have established protocols for oncologic assessment and treatment approved by United Network for Organ Sharing (UNOS).
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2504373/
Hugs,
MarionAnd a bit more- I have read that a Roux-en-Y is a surgery that would be used to remove a Klatskin tumor. Is this the case?
Hello-
I am new to this group as our 42 year old son was recently diagnosed with CCA- most likely a Klatskin. Thanks to Gavin, I now better understand this type of CCA.
The tumor (3cm) was initially diagnosed as borderline resectable and he has gone through 3 rounds of IMRT and 2 rounds of GEM/CIS. This week, we should get the results of the CT and MRI tests. The results should guide our next decisions and most likely to look for a 2nd opinion.
I, and my son, would like to benefit from your experience and knowledge. How would a Dr. decide if a Klatskin tumor is resectable or if a liver transplant is the only route.
Thank you
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