Assessment of the liver functional state in a patient with obstructive jaundice associated with the Klatskin tumor (Clinical observation)

One of the diseases of the biliary area accompanied with the obstructive jaundice syndrome is a portal cholangiocarcinoma or the Klatskin tumor. The authors assess the liver functional state in a patient with portal cholangiocarcinoma using the wedge-shaped dehydration. After diagnosing the Klatskin tumor type III by the Bismuth-Corlette scale and obstructive jaundice, the patient underwent separate external percutaneous transhepatic cholangiostomy of the right and left hepatic ducts under ultrasound and X-ray control. While making the primary percutaneous access to the biliary tract, and every three days after, the researchers studied crystallographic properties of the bile from the right and left liver lobes using the wedge-shaped dehydration method. This examination showed that the left lobe of the liver had more severe dysfunction disorders than the right one. The obtained information, laboratory and instrumental fi ndings were used to choose further management tactics and surgical modality in the described patient. The presented clinical case demonstrates the effectiveness of wedge-shaped dehydration in the dynamic assessment of liver metabolism and a possible effective application of the discussed technique in the management algorithm of patients with obstructive jaundice associated with a portal cholangiocarcinoma.

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