Cholangiocarcinoma. A place for brachytherapy.

Carcinoma arising from the common hepatic duct is unique in its clinical course and is difficult to manage due to its dismal prognosis. The case reported and the treatment reflected not only the highly selective process but also the innovation of the intracatheter brachytherapy technique available to date. Exploratory laparotomy appears essential to identify the extent of the tumor and localize the area for brachytherapy. Percutaneous transhepatic cholangiography and placements of the indwelling catheter should be reserved for non-surgical candidates whose long-term survival is limited. Review of pertinent literature also shows various roles of irradiation in the management of this disease. The potentials of intraoperative therapy, brachytherapy, external beam therapy and their combinations were examined to implement the future recommendation of the treatment.