Biliary tract Cancer: Classifications, Risk Factors & Insights
Join Dr. Gunjan Desai, a Gastrointestinal, Liver, and Pancreatic Surgeon at Lilavati Hospital, Mumbai, as he offers a comprehensive overview of biliary tract cancer (BTC) in this informative video. Tailored for medical professionals, students, and anyone interested in cutting-edge knowledge of biliary oncology, this session delves deep into the classifications, risk factors, and precursor lesions of this challenging malignancy.
Dr. Desai begins by breaking down the divisions of biliary tract cancer, explaining the key differences between intrahepatic and extrahepatic cholangiocarcinoma. He elaborates on the two primary subtypes of extrahepatic cholangiocarcinoma: perihilar cholangiocarcinoma, which occurs at the bile duct confluence, and distal cholangiocarcinoma, located closer to the pancreas. These distinctions are essential for understanding the unique clinical presentation and treatment approaches for each type.
The discussion then shifts to the detailed classifications of intrahepatic cholangiocarcinoma (ICC). Dr. Desai explores the various systems used to categorize ICC, including:
- Morphological classification: Differentiating ICC based on gross appearance.
- Differentiation-based classification: Ranging from well-differentiated to poorly differentiated tumors, which impacts prognosis.
- Small-duct vs. large-duct types: Highlighting differences in tumor biology, clinical behavior, and response to therapy.
In the next segment, Dr. Desai addresses the risk factors for intrahepatic cholangiocarcinoma, providing an in-depth look at conditions such as primary sclerosing cholangitis (PSC), liver fluke infections, chronic viral hepatitis, cirrhosis, and exposure to toxins like thorotrast. He also emphasizes how genetic predispositions and lifestyle factors, such as obesity and diabetes, play a role in increasing susceptibility to ICC.
The video concludes with a discussion on precursor lesions of intrahepatic cholangiocarcinoma, including biliary intraepithelial neoplasia (BilIN) and intracholangiocarcinoma papillary neoplasm (ICPN). Dr. Desai explains their histological features, progression to malignancy, and the importance of early detection in improving outcomes.
📌 Key Topics Covered:
- Divisions of biliary tract cancer: intrahepatic vs. extrahepatic cholangiocarcinoma.
- Subtypes of extrahepatic cholangiocarcinoma: perihilar and distal.
- Classifications of intrahepatic cholangiocarcinoma: morphological, differentiation-based, and small-duct vs. large-duct types.
- Risk factors contributing to ICC.
- Precursor lesions: their significance and progression.
Dr. Gunjan Desai brings clarity to the complex world of biliary tract cancers, equipping viewers with valuable insights for better understanding and management of these malignancies.
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