My father diagnosed with Klatskin Tumour

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    lopezmonsalve
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    My father was diagnosed with a Klatskin Tumour on May 17th.
    We are from Bogotá, Colombia.
    He is 65 years old.

    I am going to describe our experience and i hope to get your advices.

    His first and only symptom was jaundice. We went to the hospital and after some tests doctors said that he has a Klatskin Tumour.

    The tests that they did were:
    magnetic resonance cholangiography:
    Hypointense mass en T1, isointense mass in T2 at the hepatics confluence with extension to the comun hepatic and cefalic extension in the 4a segment, with not well defined edges.
    There are dilatation of the intrahepatic bile duct.
    In the seventh segment there are a Hypointense image in T1.
    There is parenchyma reduction related with the mass at the 4a segment.
    There is not lymphadenopathy.
    There is a thrombosis of the left branch of the portal vein.

    CAT scan with Contrast
    it is seen a 24 mm hypodense nodule in the right thyroid lobe.
    discrete bilateral posterior basal fibroatelectasics tracts.
    small left basal cyst of 9 mm
    no mediastinal or pleural injury
    dilatation of the intrahepatic bile duct in both lobes with bad-defined image of 28 mm at the confluence of the hepatics
    subcapsular hypodense focal lesion of 19 mm in segment vii
    pancreas and adrenal glands of normal appearance

    BONE SCAN
    negative bone metastasis

    The blood test values:
    Total bilirrubine: 21.9
    Direct Bilirrubine: 17.9
    Indirect Billirrubine: 4.0
    ca 19-9: 13.9
    ca 125 negative

    After that diagnosis they decided to put the stents.
    One stent was placed in the right bile duct, it can’t be placed in the left bile duct.
    After that procedure a pancreatitis (Balthazar b) was generated. And he was in the ICU for 3 days.

    He recovered from the pancretatitis and they did a percutaneous biopsy with negative results for malignancy.
    Then we come back to home.

    three days after that, my father have fever and vomiting. We come back to the hospital and the diagnosis was an abdominal sepsis.

    They decided to do a percutaneous biliary drainage. It was only possible at the right lobe because the left lobe has an important decrease in size.

    He was in a 14 days antibiotic treatment at the hospital and after a good response he is again at home.

    The last blood tests (June 7th) have the following values:

    Total Bilirrubine: 5.4
    Direct Bilirrubine: 3.5
    Indirect bilirrubine: 1.9
    glutamic pyruvic transaminase: 120
    glutamic oxaloacetic transaminase: 81
    alkaline phosphatase: 316
    Creatinine: 0.6

    Now we are at home expecting what kind of treatment can be done. But it is not clear because of the negative result of the biopsy.

    Have you some experience with similar cases.
    Thanks a lot.

    Daniel Lopez Monsalve

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