OPTIMIZING PERIOPERATIVE CARE FOR PERIHILAR CHOLANGIOCARCINOMA: THE CRUCIAL ROLE OF MULTIDISCIPLINARY MANAGEMENT, NEOADJUVANT THERAPY, AND INTERVENTIONAL RADIOLOGY

OTIMIZANDO O CUIDADO PERIOPERATÓRIO DE COLANGIOCARCINOMA PERIHILAR: O PAPEL FUNDAMENTAL DO MANEJO MULTIDISCIPLINAR, TERAPIA NEOADJUVANTE E RADIOLOGIA INTERVENCIONISTA

BACKGROUND:  Perihilar cholangiocarcinoma presents unique challenges in perioperative management, requiring a comprehensive approach to optimize patient outcomes.

AIMS:  This case study focuses on the multidisciplinary management and innovative interventions performed in the perioperative care of a patient with hilar cholangiocarcinoma.

METHODS:  A comprehensive assessment and treatment strategy involving neoadjuvant therapy and interventional radiology techniques were implemented. Neoadjuvant chemotherapy was administered to reduce tumor size and improve resectability. The crucial role of interventional radiology in managing postoperative complications is highlighted, particularly in the case of massive pulmonary embolism.

RESULTS:  The neoadjuvant therapy successfully reduced tumor size, enabling an R0 surgical resection. Additionally, interventional radiology interventions, such as percutaneous pharmaco-mechanical thrombectomy, effectively addressed the life-threatening complication of massive pulmonary embolism.

CONCLUSIONS:  This article highlights the importance of a collaborative, multidisciplinary approach in managing complex oncological surgeries, especially regarding the hospital’s rescue capacity for severe postoperative complications. Emergent management with interventional radiology had a central role in resolving life-threatening complications.

HEADINGS:
Cholangiocarcinoma; Postoperative complications; Hepatectomy; Pulmonary embolism; Nutrition therapy