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Treatment of Bile Duct Tumors or Klatskin Tumors

Due to the difficulties associated with the organization of treatment in Turkey, Switzerland, South Korea and India, we are not currently processing requests to these regions.

If you are interested in treatment in Germany, please leave a request and our specialists will contact you as soon as possible.

 

Cost for treatment

Bile duct cancer diagnosis
 from  3195
Diagnosis and treatment of cancer of the bile duct with bile duct obstruction by ERCP and bougienage
 from  4104
Diagnosis and treatment of cancer of the bile duct with chemotherapy
 from  2432

Academic Hospital Brothers of Mercy Munich

10/10
location_onGermany, Munich

Department of General and Abdominal Surgery

According to the Focus magazine, the Academic Hospital Brothers of Mercy Munich ranks among the top German hospitals in the Federal State of Bavaria! The hospital is a modern medical facility with the highest level of medical care and long traditions. The hospital operates on the basis of the Technical University of Munich and t
Bile duct cancer diagnosis
6569
Diagnosis and treatment of cancer of the bile duct with bile duct obstruction by ERCP and bougienage
11232
Diagnosis and treatment of cancer of the bile duct with chemotherapy
7671

University Hospital of Ludwig Maximilian University of Munich

10/10
location_onGermany, Munich

Department of General, Abdominal and Transplant Surgery

According to the Focus magazine, the University Hospital of Ludwig Maximilian University of Munich is regularly ranked among the best medical institutions in Germany! The hospital is the largest multidisciplinary medical facility, as well as a leading research and training center in Germany and Europe. The hospital is proud of i
Bile duct cancer diagnosis
7528
Diagnosis and treatment of cancer of the bile duct with bile duct obstruction by ERCP and bougienage
13408
Diagnosis and treatment of cancer of the bile duct with chemotherapy
9142

Charite University Hospital Berlin

9/10
location_onGermany, Berlin

Department of General, Abdominal and Vascular Surgery

According to the authoritative Focus magazine, the Charite University Hospital Berlin occupies the first place in the rating of the top German medical facilities! The hospital is one of the largest and leading university medical complexes in Europe. The hospital in Germany provides modern diagnostics and treatment of patients, a
Bile duct cancer diagnosis
9499
Diagnosis and treatment of cancer of the bile duct with bile duct obstruction by ERCP and bougienage
17372
Diagnosis and treatment of cancer of the bile duct with chemotherapy
7724

University Hospital Marburg UKGM

8.6/10
location_onGermany, Marburg

Department of Abdominal, Thoracic and Vascular Surgery

The University Hospital Marburg UKGM offers patients modern diagnostics and comprehensive therapy at the international level. As a maximum care hospital, the medical facility specializes in all fields of modern medicine ranging from ophthalmology to traumatology and dentistry. The main areas of specialization of the hospital are
Bile duct cancer diagnosis
6676
Diagnosis and treatment of cancer of the bile duct with bile duct obstruction by ERCP and bougienage
11304
Diagnosis and treatment of cancer of the bile duct with chemotherapy
7766

University Hospital RWTH Aachen

9.2/10
location_onGermany, Aachen

Department of Adult and Pediatric General, Abdominal, Transplant Surgery

According to the prestigious Focus magazine, the University Hospital RWTH Aachen ranks among the top German hospitals! As a maximum care university medical facility, the hospital guarantees patients first-class medical services combined with a respectful and human attitude. The hospital integrates all the modern options for the
Bile duct cancer diagnosis
7611
Diagnosis and treatment of cancer of the bile duct with bile duct obstruction by ERCP and bougienage
13327
Diagnosis and treatment of cancer of the bile duct with chemotherapy
8946

University Hospital Heidelberg

9.8/10
location_onGermany, Heidelberg

Department of General, Abdominal and Transplant Surgery

According to the Focus magazine, the University Hospital Heidelberg ranks among the top five hospitals in Germany! The hospital is one of the most advanced and reputable medical institutions not only in Germany, but throughout Europe. There are more than 43 specialized departments and 13 medical institutes, which cover all field
Bile duct cancer diagnosis
0
Diagnosis and treatment of cancer of the bile duct with bile duct obstruction by ERCP and bougienage
0
Diagnosis and treatment of cancer of the bile duct with chemotherapy
0

University Hospital Tuebingen

9.2/10
location_onGermany, Tuebingen

Department of General, Abdominal, Adult and Pediatric Transplant Surgery

According to the prestigious medical publication Focus, the University Hospital Tuebingen ranks among the top five German hospitals! The hospital was founded in 1805, therefore it is proud of its long history, unique experience, and outstanding achievements in the field of medical care, as well as research and teaching activitie
Bile duct cancer diagnosis
7182
Diagnosis and treatment of cancer of the bile duct with bile duct obstruction by ERCP and bougienage
12824
Diagnosis and treatment of cancer of the bile duct with chemotherapy
8413

University Hospital Rechts der Isar Munich

9.8/10
location_onGermany, Munich

Department of Surgery

According to the prestigious FOCUS magazine, the University Hospital Rechts der Isar Munich ranks among the Germany's top medical institutions! Founded in 1834, the hospital combines long traditions and the very latest achievements of modern medicine. The medical facility includes 33 specialized departments, 20 interdiscipli
Bile duct cancer diagnosis
7527
Diagnosis and treatment of cancer of the bile duct with bile duct obstruction by ERCP and bougienage
13237
Diagnosis and treatment of cancer of the bile duct with chemotherapy
9011

University Hospital Duesseldorf

9.5/10
location_onGermany, Duesseldorf

Department of General, Abdominal and Pediatric Surgery

According to the authoritative Focus magazine, the University Hospital Duesseldorf ranks among the top Germany hospitals! The hospital is an excellent example of a combination of high-quality health care, research and teaching activities. With more than 50,000 inpatients and about 300,000 outpatients every year, the hospital is
Bile duct cancer diagnosis
7527
Diagnosis and treatment of cancer of the bile duct with bile duct obstruction by ERCP and bougienage
13217
Diagnosis and treatment of cancer of the bile duct with chemotherapy
7663

University Hospital Erlangen

9.1/10
location_onGermany, Erlangen

Department of General, Abdominal, Endocrine, Colorectal and Bariatric Surgery

According to the Focus magazine, University Hospital Erlangen ranks among the best medical facilities in Germany! The hospital is one of the leading healthcare facilities in Bavaria and offers top-class medical care distinguished by the close intertwining of clinical activities with research and training of medical students. The
Bile duct cancer diagnosis
7238
Diagnosis and treatment of cancer of the bile duct with bile duct obstruction by ERCP and bougienage
12751
Diagnosis and treatment of cancer of the bile duct with chemotherapy
8598

HELIOS University Hospital Wuppertal

9.8/10
location_onGermany, Wuppertal

Department of General and Abdominal Surgery

The HELIOS University Hospital Wuppertal is a well-known maximum care hospital and an advanced rehabilitation center in Germany. The hospital belongs to the Witten-Herdecke University and, with its 1000 beds, is the largest one in the Bergisches Land region. Within the 26 departments of the hospital, the whole spectrum of medica
Bile duct cancer diagnosis
6939
Diagnosis and treatment of cancer of the bile duct with bile duct obstruction by ERCP and bougienage
12031
Diagnosis and treatment of cancer of the bile duct with chemotherapy
8237

University Hospital Saarland Homburg

9.8/10
location_onGermany, Homburg

Department of General, Abdominal, Vascular and Pediatric Surgery

The University Hospital Saarland is the largest hospital in the city of Homburg and the most important medical facility in the region. The hospital, which currently has 30 specialized departments and 20 institutes, was founded in 1947 and operates on the basis of the Saarland University. The hospital plays a leading role in medi
Bile duct cancer diagnosis
6711
Diagnosis and treatment of cancer of the bile duct with bile duct obstruction by ERCP and bougienage
11227
Diagnosis and treatment of cancer of the bile duct with chemotherapy
7631

Medicana International Istanbul Hospital

9/10
location_onTurkey, Istanbul

Department of General Surgery

The Medicana International Istanbul Hospital is a modern medical institution, which provides patients with an individual approach, excellent health service and attentive care. The hospital is part of the largest Turkish network of the Medicana hospitals. Due to its long successful clinical activities, the network has won th
Bile duct cancer diagnosis
6477
Diagnosis and treatment of cancer of the bile duct with bile duct obstruction by ERCP and bougienage
13312
Diagnosis and treatment of cancer of the bile duct with chemotherapy
8346

HELIOS Clinic Krefeld

9.7/10
location_onGermany, Krefeld

Department of General, Abdominal and Minimally Invasive Surgery

Founded in 2014, the HELIOS Clinic Krefeld is one of the most modern medical facilities in Germany today. A team of highly qualified specialists, innovative medical equipment and comfortable accommodation conditions – the clinic has everything to make the treatment run smoothly and efficiently. Having crossed the threshold
Bile duct cancer diagnosis
7008
Diagnosis and treatment of cancer of the bile duct with bile duct obstruction by ERCP and bougienage
11502
Diagnosis and treatment of cancer of the bile duct with chemotherapy
7809

Tel Aviv Sourasky Medical Center

9.9/10
location_onIsrael, Tel Aviv

Department of General Surgery

The Tel Aviv Sourasky Medical Center is the second largest and one of the most advanced healthcare and research facilities in Israel. It began its work in 1961, but it is still popular among the local population and attracts thousands of international patients. The multidisciplinary medical center covers an area of ​​150,000 m&s
Bile duct cancer diagnosis
6777
Diagnosis and treatment of cancer of the bile duct with bile duct obstruction by ERCP and bougienage
15009
Diagnosis and treatment of cancer of the bile duct with chemotherapy
8295

Medipol Mega University Hospital Istanbul

8/10
location_onTurkey, Istanbul

Department of General Surgery

Bile duct cancer diagnosis
6425
Diagnosis and treatment of cancer of the bile duct with chemotherapy
8809 help8249
Diagnosis and treatment of cancer of the bile duct with partial hepatectomy
47703.2 help44814
| from Booking Health GmbH

Content

  1. Overview
  2. Klatskin tumors
  3. Symptoms
  4. Diagnostics
  5. Treatment
  6. Where can I undergo bile duct cancer treatment abroad?
  7. The cost of treatment abroad
  8. How can I undergo bile duct cancer treatment abroad?

 

Bile duct cancer includes a group of tumors developing from the epithelium of the biliary tract (usually right and left hepatic ducts) that are referred to as Klatskin tumors or cholangiocarcinomas.

Overview

 

Cholangiocarcinoma is the most common malignant tumor of the bile duct and primary liver tumor after hepatocellular carcinoma. The common hepatic duct serves as the site of the division of cholangiocarcinomas into the intrahepatic and the extrahepatic ones, and the cystic duct is the border separating these two subtypes from the distal cholangiocarcinoma. In the structure of cellular cholangiocarcinoma, portal cholangiocarcinoma (hilar cholangiocarcinoma or Klatskin tumor) occupies half of all cholangiocarcinoma cases, while the intrahepatic form occupies only 8% of all cholangiocarcinoma cases.

Klatskin tumors

 

In 1946, Dr. Klatskin founded the laboratory, which eventually became known as the department for the study of the hepatobiliary system. In 1965, he described the unique features of hilar cholangiocarcinoma, which bears his name since.

Depending on the localization, the incidence of cholangiocellular cancer varies from 1 to 7 cases per 100,000 population, and 40-60% of all cases are related to the Klatskin tumor.

Histologically, Klatskin tumor or hilar cholangiocarcinoma in most cases is a highly or moderately differentiated adenocarcinoma with slow growth, metastases in the lymph nodes, relatively late hematogenous metastasizing, longitudinal and radial spreading along the bile duct and into the depth of its wall. Due to the sub-epithelial growth of the Klatskin tumor (hilar cholangiocarcinoma) along the bile duct under the externally healthy mucous membrane, the actual spreading of tumor cells may exceed the macroscopically visible lesion by 5-10 mm, which significantly complicates the possibility of its surgical treatment.

Klatskin tumors or hilar cholangiocarcinomas usually appear at the age of 50-70 and, according to statistics, are somewhat more common in men. Patients usually do not experience any symptoms until the advanced stages of the disease, where jaundice is the main manifestation. Abdominal pain, weight loss, and malaise are other symptoms that some patients experience. Metastasizing to regional lymph nodes is common.

In 90% of cases, Klatskin tumors appear sporadically, but certain risk factors are still associated with this disease. These risk factors include primary sclerosing cholangitis, secondary sclerosing cholangitis, chronic typhoid fever, parasitic infections, and all the choledochus cysts (bile duct cysts) that cause chronic inflammation of the hepatobiliary system.

The main goals of treatment are the relief of biliary block and tumor resection. As Klatskin tumors (hilar cholangiocarcinomas) are generally resistant to chemotherapy and radiation therapy, surgical resection is the only efficient treatment, but this option is not always suitable for patients with advanced disease stages.

Surgical treatment involves liver resection with caudal lobectomy, which is more likely to reach the negative margin of the tumor.

Unresectable Klatskin tumors are treated with radiation therapy and/or chemotherapy. Gemcitabine in combination with cisplatin therapy has been recognized as the standard treatment for patients with unresectable biliary tract tumors, including Klatskin tumors (hilar cholangiocarcinomas).

Klatskin tumor is the cholangiocarcinoma located at the confluence of hepatic bile ducts.

Best treatments for bile duct cancer are surgery and endovascular treatment (chemoembolization).

The leading hospitals in Europe are Academic Hospital of the Brothers of Mercy and University Hospital of the University of Munich Ludwig Maximilian (Germany).

Prices are as follows:

ProcedureCost
Partial hepatectomyfrom 22,269 €
ERCP and bougienagefrom 4,041 €
Chemotherapyfrom 2,405 €

 

Symptoms

 

Biliary tract cancer includes:

  • Cancer of the intrahepatic biliary tract
  • Cancer of the extrahepatic biliary tract – Klatskin tumor (hilar cholangiocarcinoma)

Cholangiocarcinoma and other tumors of the bile duct are rare (1-2 cases per 100,000 people), but are usually malignant. Cholangiocarcinoma mainly affects the extrahepatic type of the bile ducts: 60-70% of cases occur in the area of the liver hilum (Klatskin tumor), about 25% – in the distal segments of the bile ducts, in other cases, other liver parts are affected. It is believed that tumors of the biliary tract account for about 3% of all tumors of the gastrointestinal tract, while intrahepatic cholangiocarcinomas account for about 10% of cases of primary liver cancer. Among cholangiocarcinomas, Klatskin tumor accounts for 50% of cases, 40% of which are the tumors of distal localization.

Tumors with damage to the bile ducts are related to tumors of extrahepatic localization (Klatskin tumor).

Most patients with cholangiocarcinoma deal with painless obstructive jaundice, usually between the ages of 50-70. Early stage tumors located at the hilum of the liver can only cause abdominal pain, anorexia, and weight loss. Other symptoms may include fatigue, acholic stools (usually indicate jaundice), hepatomegaly (enlarged liver), or an enlarged gallbladder (Courvoisier's symptom in distal cholangiocarcinoma). Pain may resemble biliary colic (reflects biliary obstruction) and be persistent or progressive. Sepsis (with acute cholangitis) is not a typical complication but may be confirmed or excluded with endoscopic retrograde cholangiopancreatography.

Risk factors include age, presence of primary sclerosing cholangitis, hepatic fluke invasion, and cysts in the bile duct.

Diagnostics

 

Methods that are used for the confirmation of cholangiocarcinoma diagnosis in European hospitals include:

  • Ultrasonography (sometimes endoscopic ultrasonography) followed by CT cholangiography or magnetic resonance cholangiopancreatography
  • Endoscopic retrograde cholangiopancreatography, if indicated

Cholangiocarcinomas are suspected in cases of unexplained obstruction of the bile ducts. In patients with primary sclerosing cholangitis, levels of carcinoembryonic antigen (CEA) and cancer antigen CA-19-9 in the blood are examined to exclude cholangiocarcinoma presence.

CT scan is often done, which can provide more information than ultrasonography, especially in the diagnosis of cholangiocarcinomas. If these methods do not provide a doctor with the sufficient information about the disease, then endoscopic retrograde cholangiopancreatography with percutaneous transhepatic cholangiography is performed. Endoscopic retrograde cholangiopancreatography allows not only detecting a tumor but also performing a biopsy to confirm the diagnosis. CT scan with a contrast agent also helps in determining the stage of the disease.

Open laparotomy is sometimes used in European hospitals to determine the spreading of the pathological process, which makes it possible to choose the most suitable therapeutic tactics.

Treatment

 

Cholangiocarcinoma was originally considered a tumor with an unfavourable prognosis. Until now, surgical treatment has been the only relatively effective approach. However, even this treatment method is an option for only 35% of patients. Another 35% mostly are patients with unresectable tumors or other health conditions that make them not eligible for surgery.

For 10 years, chemotherapy based on a combination of gemcitabine and cisplatin has remained the standard first-line therapy in patients with locally advanced or metastatic cholangiocarcinoma. Attempts to use various chemotherapeutic regimens, both in monotherapy and in combinations, have been relatively successful. In order not to leave the patient without treatment, fluoropyrimidines in combination with oxaliplatin or irinotecan, are empirically prescribed as the consolidation therapy.

The treatment method, however, always depends on the localization of cholangiocarcinoma, which is divided into intrahepatic, distal (localized below the cystic bile duct), and hilar cholangiocarcinoma (Klatskin tumor) that is localized in the area of confluence of the bile ducts.

The only effective treatment for patients with Klatskin tumor is surgery, and the only way to achieve long-term survival is to provide an R0 resection (microscopically margin-negative resection). Taking into account the peculiarities of the anatomical structure of the hepatic hilum, the surgical procedure is an extremely difficult task that can be solved only by performing an extended liver resection with total caudate lobectomy with hepaticoholedochus, wide lymphadenectomy, and often resection of the portal vein, hepatic artery. The procedure is often followed by the liver transplantation.

Where can I undergo bile duct cancer treatment abroad?

 

Health tourism is becoming more and more popular these days, as treatment abroad often ensures a much better quality of bile duct cancer treatment.

Many European hospitals show high success rates in bile duct cancer treatment.

Experienced oncologists in European hospitals provide the most modern techniques of treatment of oncological diseases, including bile duct cancer.

The benefits of treatment abroad include:

  • Up-to-date equipment for treatment and diagnosis of bile duct cancer and other liver tumors from leading brands
  • The high level of expertise of oncologists and oncologic surgeons, proved by positive treatment results
  • Treatment according to international protocols
  • Comfortable and fully equipped hospitals

You can find more information about the hospitals specializing in liver cancer treatment on the Booking Health website.

The cost of treatment abroad

 

The prices in hospitals listed on the Booking Health website are relatively low. With Booking Health, you can undergo bile duct cancer treatment at an affordable price.

The cost of treatment of bile duct cancer varies, as the prices depend on the hospitals, the specifics of the disease, and the complexity of its treatment. You should also consider the cost of possible additional procedures and follow-up care. Therefore, the ultimate cost of treatment of bile duct cancer may differ from the initial price.

To make sure that the overall cost of treatment in European hospitals is suitable for you, you may contact us by leaving the request on the Booking Health website.

How can I undergo bile duct cancer treatment abroad?

 

It is not easy to self-organize any treatment abroad. It requires certain knowledge and expertise. Thus, it is safer, easier, and less stressful to use the services of a medical tourism agency.

As the largest and most transparent medical tourism agency in the world, Booking Health has up-to-date information about bile duct cancer treatment in the best hospitals. We will help you select the right European hospital according to your wishes.

We want to help you and take on all the troubles. You can be free of unnecessary stress, while Booking Health takes care of all organizational issues regarding the treatment. Our services aimed at undergoing bile duct cancer treatment abroad safely and successfully.

Medical tourism can be easy! All you need to do is to leave a request on the Booking Health website, and our manager will contact you shortly.

Authors: Dr. Nadezhda Ivanisova, Dr. Sergey Pashchenko




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