medvisМедицинская визуализацияMedical Visualization1607-07632408-9516RDS-Media Ltd.medvis-4Research ArticleБРЮШНАЯ ПОЛОСТЬABDOMENСовременные методы диагностики холангиоцеллюлярного ракаModern Diagnostic Methods of CholangiocarcinomaДанзановаТатьяна ЮрьевнаDanzanovaTatiana Yurevnadanzanova@yandex.ruСинюковаГалина ТимофеевнаSinyukovaGalina Timofeevnanoemail@neicon.ruЛепэдатуПавел ИвановичLepedatuPavel Ivanovichnoemail@neicon.ruФГБУ "Российский онкологический центр им. Н.Н. Блохина" РАМНРоссияN.N. Blokhin Russian Oncological Centre RAMSciRussian Federation201428022014012236Copyright © Данзанова Т.Ю., Синюкова Г.Т., Лепэдату П.И., 20142014Данзанова Т.Ю., Синюкова Г.Т., Лепэдату П.И.Danzanova T.Y., Sinyukova G.T., Lepedatu P.I.This work is licensed under a Creative Commons Attribution 4.0 License.https://medvis.vidar.ru/jour/article/view/4

Цель: представить особенности современной диагностики холангиоцеллюлярного рака (ХЦР). Основные положения. В статье описана классификация, частота встречаемости, факторы риска развития ХЦР. Рассмотрены диагностические возможности трансабдоминального, эндоскопического и внутрипротокового УЗИ, а также РКТ, МРТ, ПЭТ и холангиографии в обнаружении внутри- и внепеченочной формы ХЦР, локорегионарного распространения опухоли. Расширение желчного протока на ультразвуковых томограммах - важный признак для ранней диагностики рака желчного протока и повод для проведения более масштабного обследования с применением других информативных методов. УЗИ - метод выбора при проведении интервенционных процедур, таких как чрескожная чреспеченочная холангиография и дренирование перибилиарных абсцессов. Разработка новых методов исследования желчных протоков привела к использованию УЗИ при проведении эндоскопии - эндоскопического УЗИ и при проведении холангиопанкреатографии-транспапиллярного внутрипротокового УЗИ. Выводы. Большинство авторов считают, что диагностические методы для карциномы желчных протоков без желтухи включают УЗИ, МРХПГ, ЭУЗИ, ЭРХПГ и внутри-протоковое УЗИ, ас желтухой УЗИ, РКТ или МРТ, пункцию под контролем ЭУЗИ, ЭРХПГ. ПЭТ с успехом справляется с диагностикой внутрипеченочной формы ХЦР, но имеет низкие показатели информативности в обнаружении внепеченочного ХЦР. Ее роль заключается в выявлении отдаленных метастазов и оценке эффективности лечения.

The purpose: submit a feature of modern diagnostics cholangiocarcinoma. The main provisions. The article describes the classification, incidence, risk factors for cholangiocarcinoma. Considered diagnostic capabilities of techniques of transabdominal, endoscopic and intraductal ultrasound and CT MRI, PET and cholangiography in the detection of extrahepatic and intrahepatic cholangiocarcinoma, locoregional tumor spread. The expansion of the bile duct on ultrasound tomograms-an important feature for the early diagnosis of cancer of the bile duct and the reason for a larger survey using other informative methods. Ultrasound examination - the method of choice for interventional procedures such as percutaneous transhepatic cholangiography and drainage of abscesses peribiliary. The development of new methods of investigation bile duct led to the use of ultrasound during endoscopy-endoscopic ultrasound and during cholangiopancreatogra-phy-transpapillary intraductal ultrasonography. Conclusion. Most authors believe that the diagnostic methods for bile duct carcinoma without jaundice include ultrasound, MRCP, EUS, ERCP and intraductal ultrasound. Diagnostic methods for carcinoma of the bile duct with jaundice: ultrasound, CT or MRI, puncture under the control of EUS, ERCP. PET successfully identifies intrahepatic cholangiocarcinoma, but has a poor performance in detecting informative extrahepatic cholangiocarcinoma. Its role is to identify distant metastases and assessment of treatment efficacy.

холангиоцеллюлярный ракжелтухаультразвуковое исследованиерентгеновская компьютерная томографиямагнитно-резонансная томографияпозитронно-эмиссионная томографияcholangiocellular cancerjaundiceultrasoundx-ray computed tomographymagnetic resonance tomographypositron emission tomographyReferencesEverhart J.E., Ruhl C.E. Burden of digestive diseases in the United States Part III: liver, biliary tract, and pancreas. Gastroenterology. 2009; 136: 1134-1144.Everhart J.E., Ruhl C.E. Burden of digestive diseases in the United States Part III: liver, biliary tract, and pancreas. Gastroenterology. 2009; 136: 1134-1144.Blechacz B., Komuta M., Roskams T. et al. Clinical diagnosis and staging of cholangiocarcinoma. Nat. Rev. Gastroenterol. Hepatol. 2011; 8 (9): 512-522.Blechacz B., Komuta M., Roskams T. et al. Clinical diagnosis and staging of cholangiocarcinoma. Nat. Rev. Gastroenterol. Hepatol. 2011; 8 (9): 512-522.DeOliveira M.L., Schulick R.D., Nimura Y. et al. New staging system and a registry for perihilar cholangiocarcinoma. Hepatology. 2011; 53: 1363-1371.DeOliveira M.L., Schulick R.D., Nimura Y. et al. New staging system and a registry for perihilar cholangiocarcinoma. Hepatology. 2011; 53: 1363-1371.Ito Y., Tajima Y., Fujita F. et al. Solitary recurrence of hilar cholangiocarcinoma in a mediastinal lymph node two years after curative resection. Wld J. Gastroenterol. 2007; 13: 2243-2246.Ito Y., Tajima Y., Fujita F. et al. Solitary recurrence of hilar cholangiocarcinoma in a mediastinal lymph node two years after curative resection. Wld J. Gastroenterol. 2007; 13: 2243-2246.Tao L.Y., He X.D., Qu Q. et al. Risk factors for intrahepatic and extrahepatic cholangiocarcinoma: a case-control study in China. Liver Int. 2010; 30: 215-221.Tao L.Y., He X.D., Qu Q. et al. Risk factors for intrahepatic and extrahepatic cholangiocarcinoma: a case-control study in China. Liver Int. 2010; 30: 215-221.Morana G., Dorigo A. Imaging of cholangiocarcinoma. Cancer Imaging. 2011; 11 Spec No A: S72-S73.Morana G., Dorigo A. Imaging of cholangiocarcinoma. Cancer Imaging. 2011; 11 Spec No A: S72-S73.Friman S. Cholangiocarcinoma - current treatment options. Scand. J. Surg. 2011; 100 (1): 30-34.Friman S. Cholangiocarcinoma - current treatment options. Scand. J. Surg. 2011; 100 (1): 30-34.Eckel F., Brunner T., Jelic S. Biliary cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann. Oncol. 2010; 21, Suppl. 5: v65-v69.Eckel F., Brunner T., Jelic S. Biliary cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann. Oncol. 2010; 21, Suppl. 5: v65-v69.Miyakawa S., Ishihara S., Horiguchi A. et al. Biliary tract cancer treatment: 5,584 results from the Biliary Tract Cancer Statistics Registry from 1998 to 2004 in Japan. J. Hepatobil. Pancreat. Surg. 2009; 16: 1-7.Miyakawa S., Ishihara S., Horiguchi A. et al. Biliary tract cancer treatment: 5,584 results from the Biliary Tract Cancer Statistics Registry from 1998 to 2004 in Japan. J. Hepatobil. Pancreat. Surg. 2009; 16: 1-7.Tamada K., Ushio J., Sugano K. Endoscopic diagnosis of extrahepatic bile duct carcinoma: Advances and current limitations. Wld J. Clin. Oncol. 2011; 2 (5): 203-216.Tamada K., Ushio J., Sugano K. Endoscopic diagnosis of extrahepatic bile duct carcinoma: Advances and current limitations. Wld J. Clin. Oncol. 2011; 2 (5): 203-216.Zabron A., Edwards R.J., Khan S.A. The challenge of cholangiocarcinoma: dissecting the molecular mechanisms of an insidious cancer. Dis. Model. Mech. 2013; 6 (2): 281-292.Zabron A., Edwards R.J., Khan S.A. The challenge of cholangiocarcinoma: dissecting the molecular mechanisms of an insidious cancer. Dis. Model. Mech. 2013; 6 (2): 281-292.Хамидуллин Р.И., Аглуллин И.Р., Рахманин Ю.А. и др. Паразитарный фактор и рак. Гиг. и сан. 2011; 6: 8-11.Хамидуллин Р.И., Аглуллин И.Р., Рахманин Ю.А. и др. Паразитарный фактор и рак. Гиг. и сан. 2011; 6: 8-11.Razumilava N., Gores G.J. Classification, diagnosis, and management of cholangiocarcinoma. Clin. Gastroenterol. Hepatol. 2013; 11 (1):13-21.Razumilava N., Gores G.J. Classification, diagnosis, and management of cholangiocarcinoma. Clin. Gastroenterol. Hepatol. 2013; 11 (1):13-21.Nathan H., Aloia T.A., Vauthey J.N. et al. A proposed staging system for intrahepatic cholangiocarcinoma. Ann. Surg. Oncol. 2009; 16: 14-22.Nathan H., Aloia T.A., Vauthey J.N. et al. A proposed staging system for intrahepatic cholangiocarcinoma. Ann. Surg. Oncol. 2009; 16: 14-22.Shimada K., Sano T., Sakamoto Y. et al. Surgical outcomes of the mass-forming plus periductal infiltrating types of intrahepatic cholangiocarcinoma: a comparative study with the typical mass-forming type of intrahepatic cholangiocarcinoma. Wld J. Surg. 2007; 31: 2016-2022.Shimada K., Sano T., Sakamoto Y. et al. Surgical outcomes of the mass-forming plus periductal infiltrating types of intrahepatic cholangiocarcinoma: a comparative study with the typical mass-forming type of intrahepatic cholangiocarcinoma. Wld J. Surg. 2007; 31: 2016-2022.Yamamoto Y., Shimada K., Sakamoto Y. et al. Clinicopathological characteristics of intrahepatic cholangiocellular carcinoma presenting intrahepatic bile duct growth. J. Surg. Oncol. 2009; 99: 161-165.Yamamoto Y., Shimada K., Sakamoto Y. et al. Clinicopathological characteristics of intrahepatic cholangiocellular carcinoma presenting intrahepatic bile duct growth. J. Surg. Oncol. 2009; 99: 161-165.Wiedmann M., Schoppmeyer K., Witzigmann H. et al. Current diagnostics and therapy for carcinomas of the biliary tree and gallbladder. J. Gastroenterol. 2005; 43 (3): 305-315.Wiedmann M., Schoppmeyer K., Witzigmann H. et al. Current diagnostics and therapy for carcinomas of the biliary tree and gallbladder. J. Gastroenterol. 2005; 43 (3): 305-315.Chung Y.J., Choi D.W., Choi S.H. et al. Prognostic factors following surgical resection of distal bile duct cancer. J. Korean. Surg. Soc. 2013; 85 (5): 212-218.Chung Y.J., Choi D.W., Choi S.H. et al. Prognostic factors following surgical resection of distal bile duct cancer. J. Korean. Surg. Soc. 2013; 85 (5): 212-218.Minami Y., Kudo M. Hepatic malignancies: Correlation between sonographic findings and pathological features. Wld J. Radiol. 2010; 2 (7): 249-256.Minami Y., Kudo M. Hepatic malignancies: Correlation between sonographic findings and pathological features. Wld J. Radiol. 2010; 2 (7): 249-256.Измайлова Л.Г., Приходько А.Г., Андреев А.В. и др. Ультразвуковая диагностика гилюсной холангиокарциномы. Мед. виз. 2011; 6: 9-12.Измайлова Л.Г., Приходько А.Г., Андреев А.В. и др. Ультразвуковая диагностика гилюсной холангиокарциномы. Мед. виз. 2011; 6: 9-12.Aljiffry M., Walsh M.J., Molinari M. Advances in diagnosis, treatment and palliation of cholangiocarcinoma: 1990-2009. Wld J. Gastroenterol. 2009; 15 (34): 4240-4262.Aljiffry M., Walsh M.J., Molinari M. Advances in diagnosis, treatment and palliation of cholangiocarcinoma: 1990-2009. Wld J. Gastroenterol. 2009; 15 (34): 4240-4262.D'Onofrio M., Vecchiato F., Cantisani V. et al. Intrahepatic peripheral cholangiocarcinoma (IPCC): comparison between perfusion ultrasound and CT imaging. Radiol. Med. 2008; 113 (1): 76-86.D'Onofrio M., Vecchiato F., Cantisani V. et al. Intrahepatic peripheral cholangiocarcinoma (IPCC): comparison between perfusion ultrasound and CT imaging. Radiol. Med. 2008; 113 (1): 76-86.Chen L.D., Xu H.X., Xie X.Y. et al. Enhancement patterns of intrahepatic cholangiocarcinoma: comparison between contrast-enhanced ultrasound and contrast-enhanced CT. Br. J. Radiol. 2008; 81 (971): 881-889.Chen L.D., Xu H.X., Xie X.Y. et al. Enhancement patterns of intrahepatic cholangiocarcinoma: comparison between contrast-enhanced ultrasound and contrast-enhanced CT. Br. J. Radiol. 2008; 81 (971): 881-889.Xu H.X. Contrast-enhanced ultrasound in the biliary system: Potential uses and indications. Wld J. Radiol. 2009; 1 (1): 37-44.Xu H.X. Contrast-enhanced ultrasound in the biliary system: Potential uses and indications. Wld J. Radiol. 2009; 1 (1): 37-44.Foley W.D., Quiroz F.A. The role of sonography in imaging of the biliary tract. Ultrasound Q. 2007; 23 (2): 123-135.Foley W.D., Quiroz F.A. The role of sonography in imaging of the biliary tract. Ultrasound Q. 2007; 23 (2): 123-135.Zhimin G., Noor H., Jian-Bo Z. et al. Advances in diagnosis and treatment of hilar cholangiocarcinoma - a review. Med. Sci Monit. 2013; 19: 648-556.Zhimin G., Noor H., Jian-Bo Z. et al. Advances in diagnosis and treatment of hilar cholangiocarcinoma - a review. Med. Sci Monit. 2013; 19: 648-556.Asayama Y., Yoshimitsu K., Irie H. et al. Delayed-phase dynamic CT enhancement as a prognostic factor for mass-forming intrahepatic cholangiocarcinoma. Radiology. 2006; 238: 150-155.Asayama Y., Yoshimitsu K., Irie H. et al. Delayed-phase dynamic CT enhancement as a prognostic factor for mass-forming intrahepatic cholangiocarcinoma. Radiology. 2006; 238: 150-155.Okumoto T., Sato A., Yamada T. et al. Correct diagnosis of vascular encasement and longitudinal extension of hilar cholangiocarcinoma by four-channel multidetector-row computed tomography. Tohoku J. Exp. Med. 2009; 217 (1): 1-8.Okumoto T., Sato A., Yamada T. et al. Correct diagnosis of vascular encasement and longitudinal extension of hilar cholangiocarcinoma by four-channel multidetector-row computed tomography. Tohoku J. Exp. Med. 2009; 217 (1): 1-8.Watadani T., Akahane M., Yoshikawa T. et al. Preoperative assessment of hilar cholangiocarcinoma using multidetector-row CT: correlation with histopathological findings. Radiat. Med. 2008; 26: 402-407.Watadani T., Akahane M., Yoshikawa T. et al. Preoperative assessment of hilar cholangiocarcinoma using multidetector-row CT: correlation with histopathological findings. Radiat. Med. 2008; 26: 402-407.Seo H., Lee J.M., Kim I.H. et al. Evaluation of the gross type and longitudinal extent of extrahepatic cholangiocarcinomas on contrast-enhanced multidetector row computed tomography. J. Comput. Assist. Tomogr. 2009; 33: 376-382.Seo H., Lee J.M., Kim I.H. et al. Evaluation of the gross type and longitudinal extent of extrahepatic cholangiocarcinomas on contrast-enhanced multidetector row computed tomography. J. Comput. Assist. Tomogr. 2009; 33: 376-382.Blechacz B., Gores G.J. Cholangiocarcinoma: advances in pathogenesis, diagnosis, and treatment. Hepatology. 2008; 48 (1): 308-321.Blechacz B., Gores G.J. Cholangiocarcinoma: advances in pathogenesis, diagnosis, and treatment. Hepatology. 2008; 48 (1): 308-321.Lee H.Y., Kim S.H., Lee J.M. et al. Preoperative assessment of resectability of hepatic hilar cholangiocarcinoma: combined CT and cholangiography with revised criteria. Radiology. 2006; 239: 113-121.Lee H.Y., Kim S.H., Lee J.M. et al. Preoperative assessment of resectability of hepatic hilar cholangiocarcinoma: combined CT and cholangiography with revised criteria. Radiology. 2006; 239: 113-121.Khan S.A., Miras A., Pelling M. et al. Cholangiocarcinoma and its management. Gut. 2007; 56: 1755-1756.Khan S.A., Miras A., Pelling M. et al. Cholangiocarcinoma and its management. Gut. 2007; 56: 1755-1756.Masselli G., Gualdi G. Hilar cholangiocarcinoma: MRI/MRCP in staging and treatment planning. Abdom. Imaging. 2008; 33 (4): 444-451.Masselli G., Gualdi G. Hilar cholangiocarcinoma: MRI/MRCP in staging and treatment planning. Abdom. Imaging. 2008; 33 (4): 444-451.Майстренко Н.А., Шейко С.В., Алентьев А.В. и др. Холангиоцеллюлярный рак (особенности диагностики и лечения). Практ. онкол. 2008; 9 (4): 229-236.Майстренко Н.А., Шейко С.В., Алентьев А.В. и др. Холангиоцеллюлярный рак (особенности диагностики и лечения). Практ. онкол. 2008; 9 (4): 229-236.Valero V. 3rd, Cosgrove D., Herman J.M. et al. Management of perihilar cholangiocarcinoma in the era of multimodal therapy. Expert. Rev. Gastroenterol. Hepatol. 2012; 6 (4): 481-495.Valero V. 3rd, Cosgrove D., Herman J.M. et al. Management of perihilar cholangiocarcinoma in the era of multimodal therapy. Expert. Rev. Gastroenterol. Hepatol. 2012; 6 (4): 481-495.Gorycki T., Studniarek M. Bile Duct Strictures Caused by Solid Masses: MR in Differential Diagnosis and as a Prognostic Tool to Plan the Endoscopic Treatment. Gastroenterol. Res. Pract. 2013; 2013, Article ID 729279: 7.Gorycki T., Studniarek M. Bile Duct Strictures Caused by Solid Masses: MR in Differential Diagnosis and as a Prognostic Tool to Plan the Endoscopic Treatment. Gastroenterol. Res. Pract. 2013; 2013, Article ID 729279: 7.Gore R.M., Shelhamer R.P. Biliary tract neoplasms: diagnosis and staging. Cancer Imaging. 2007; 7 Spec No A: S15-S23.Gore R.M., Shelhamer R.P. Biliary tract neoplasms: diagnosis and staging. Cancer Imaging. 2007; 7 Spec No A: S15-S23.Vilgrain V. Staging cholangiocarcinoma by imaging studies. HPB (Oxford). 2008; 10 (2): 106-109.Vilgrain V. Staging cholangiocarcinoma by imaging studies. HPB (Oxford). 2008; 10 (2): 106-109.Lee M.G., Park K.B., Shin Y.M. et al. Preoperative evaluation of hilar cholangiocarcinoma with contrast-enhanced three-dimensional fast imaging with steady-state precession magnetic resonance angiography: comparison with intraarterial digital subtraction angiography. Wld J. Surg. 2003; 27: 278-283.Lee M.G., Park K.B., Shin Y.M. et al. Preoperative evaluation of hilar cholangiocarcinoma with contrast-enhanced three-dimensional fast imaging with steady-state precession magnetic resonance angiography: comparison with intraarterial digital subtraction angiography. Wld J. Surg. 2003; 27: 278-283.Hanninen E.L., Pech M., Jonas S. et al. Magnetic resonance imaging including magnetic resonance cholangiopancreatography for tumor localization and therapy planning in malignant hilar obstructions. Acta Radiol. 2005; 46: 462-470.Hanninen E.L., Pech M., Jonas S. et al. Magnetic resonance imaging including magnetic resonance cholangiopancreatography for tumor localization and therapy planning in malignant hilar obstructions. Acta Radiol. 2005; 46: 462-470.Masselli G., Manfredi R., Vecchioli A. et al. MR imaging and MR cholangiopancreatography in the preoperative evaluation of hilar cholangiocarcinoma: correlation with surgical and pathologic findings. Eur. Radiol. 2008; 18: 2213-2221.Masselli G., Manfredi R., Vecchioli A. et al. MR imaging and MR cholangiopancreatography in the preoperative evaluation of hilar cholangiocarcinoma: correlation with surgical and pathologic findings. Eur. Radiol. 2008; 18: 2213-2221.Larghi A., Lecca P.G., Ardito F. et al. Evaluation of hilar biliary strictures by using a newly developed forward-viewing therapeutic echoendoscope: preliminary results of an ongoing experience. Gastrointest. Endosc. 2009; 69: 356-360.Larghi A., Lecca P.G., Ardito F. et al. Evaluation of hilar biliary strictures by using a newly developed forward-viewing therapeutic echoendoscope: preliminary results of an ongoing experience. Gastrointest. Endosc. 2009; 69: 356-360.Назыров Ф.Г., Икрамов А.И., Акбаров М.М. и др. Диагностика и тактика хирургического лечения больных опухолями проксимальных отделов внепеченочных желчных протоков. Хирургия. Журн. им. Н.И. Пирогова. 2010; 6: 36-39.Назыров Ф.Г., Икрамов А.И., Акбаров М.М. и др. Диагностика и тактика хирургического лечения больных опухолями проксимальных отделов внепеченочных желчных протоков. Хирургия. Журн. им. Н.И. Пирогова. 2010; 6: 36-39.Lee T.H. Technical tips and issues of biliary stenting, focusing on malignant hilar obstruction. Clin. Endosc. 2013; 46 (3): 260-266.Lee T.H. Technical tips and issues of biliary stenting, focusing on malignant hilar obstruction. Clin. Endosc. 2013; 46 (3): 260-266.Akamatsu N., Sugawara Y., Hashimoto D. Surgical strategy for bile duct cancer: Advances and current limitations. Wld J. Clin. Oncol. 2011; 2 (2): 94-107.Akamatsu N., Sugawara Y., Hashimoto D. Surgical strategy for bile duct cancer: Advances and current limitations. Wld J. Clin. Oncol. 2011; 2 (2): 94-107.Lazaridis K.N., Gores G.J. Cholangiocarcinoma. Gastroenterology. 2005; 128: 1655-1667.Lazaridis K.N., Gores G.J. Cholangiocarcinoma. Gastroenterology. 2005; 128: 1655-1667.Domagk D., Poremba C., Dietl K.H. et al. Endoscopic transpapillary biopsies and intraductal ultrasonography in the diagnostics of bile duct strictures: a prospective study. Gut. 2002; 51: 240-244.Domagk D., Poremba C., Dietl K.H. et al. Endoscopic transpapillary biopsies and intraductal ultrasonography in the diagnostics of bile duct strictures: a prospective study. Gut. 2002; 51: 240-244.Hattori M., Nagino M., Ebata T. et al. Prospective study of biliary cytology in suspected perihilar cholangiocarcinoma. Br. J. Surg. 2011; 98: 704-709.Hattori M., Nagino M., Ebata T. et al. Prospective study of biliary cytology in suspected perihilar cholangiocarcinoma. Br. J. Surg. 2011; 98: 704-709.Halling K.C., Kipp B.R. Fluorescence in situ hybridization in diagnostic cytology. Hum. Pathol. 2007; 38: 1137-1144.Halling K.C., Kipp B.R. Fluorescence in situ hybridization in diagnostic cytology. Hum. Pathol. 2007; 38: 1137-1144.Baskin-Bey E.S., Moreno Luna L.E., Gores G.J. Diagnosis of cholangiocarcinoma in patients with PSC: a sight on cytology. J. Hepatol. 2006; 45: 476-479.Baskin-Bey E.S., Moreno Luna L.E., Gores G.J. Diagnosis of cholangiocarcinoma in patients with PSC: a sight on cytology. J. Hepatol. 2006; 45: 476-479.Topazian M. Clin Endoscopic ultrasonography in the evaluation of indeterminate biliary strictures. Endoscopy. 2012; 45 (3): 328-330.Topazian M. Clin Endoscopic ultrasonography in the evaluation of indeterminate biliary strictures. Endoscopy. 2012; 45 (3): 328-330.Brugge W.R. Advances in the endoscopic management of patients with pancreatic and biliary malignancies. South. Med. J. 2006; 99: 1358-1366.Brugge W.R. Advances in the endoscopic management of patients with pancreatic and biliary malignancies. South. Med. J. 2006; 99: 1358-1366.Heimbach J.K., Sanchez W., Rosen C.B. et al. Trans-peritoneal fine needle aspiration biopsy of hilar cholangiocarcinoma is associated with disease dissemination. HPB (Oxford). 2011; 13: 356-360.Heimbach J.K., Sanchez W., Rosen C.B. et al. Trans-peritoneal fine needle aspiration biopsy of hilar cholangiocarcinoma is associated with disease dissemination. HPB (Oxford). 2011; 13: 356-360.Eloubeidi M.A., Chen V.K., Jhala N.C. et al. Endoscopic ultrasound-guided fine needle aspiration biopsy of suspected cholangiocarcinoma. Clin. Gastroenterol. Hepatol. 2004; 2: 209-213.Eloubeidi M.A., Chen V.K., Jhala N.C. et al. Endoscopic ultrasound-guided fine needle aspiration biopsy of suspected cholangiocarcinoma. Clin. Gastroenterol. Hepatol. 2004; 2: 209-213.Levy M.J., Heimbach J.K., Gores G.J. Endoscopic ultrasound staging of cholangiocarcinoma. Curr. Opin. Gastroenterol. 2012; 28 (3): 244-252.Levy M.J., Heimbach J.K., Gores G.J. Endoscopic ultrasound staging of cholangiocarcinoma. Curr. Opin. Gastroenterol. 2012; 28 (3): 244-252.Varadarajulu S., Eloubeidi M.A., Wilcox C.M. Prospective evaluation of indeterminate ERCP findings by intraductal ultrasound. J. Gastroenterol. Hepatol. 2007; 22: 2086-2092.Varadarajulu S., Eloubeidi M.A., Wilcox C.M. Prospective evaluation of indeterminate ERCP findings by intraductal ultrasound. J. Gastroenterol. Hepatol. 2007; 22: 2086-2092.Levy M.J., Baron T.H., Clayton A.C. et al. Prospective evaluation of advanced molecular markers and imaging techniques in patients with indeterminate bile duct strictures. Am. J. Gastroenterol. 2008; 103: 1263-1273.Levy M.J., Baron T.H., Clayton A.C. et al. Prospective evaluation of advanced molecular markers and imaging techniques in patients with indeterminate bile duct strictures. Am. J. Gastroenterol. 2008; 103: 1263-1273.Brugge W.R. Endoscopic techniques to diagnose and manage biliary tumors. J. Clin. Oncol. 2005; 23: 4561-4565.Brugge W.R. Endoscopic techniques to diagnose and manage biliary tumors. J. Clin. Oncol. 2005; 23: 4561-4565.Meister T., Heinzow H.S., Woestmeyer C. et al. Intraductal ultrasound substantiates diagnostics of bile duct strictures of uncertain etiology. Wld J. Gastroenterol. 2013; 19 (6): 874-881.Meister T., Heinzow H.S., Woestmeyer C. et al. Intraductal ultrasound substantiates diagnostics of bile duct strictures of uncertain etiology. Wld J. Gastroenterol. 2013; 19 (6): 874-881.Stavropoulos S., Larghi A., Verna E. et al. Intraductal ultrasound for the evaluation of patients with biliary strictures and no abdominal mass on computed tomography. Endoscopy. 2005; 37: 715-721.Stavropoulos S., Larghi A., Verna E. et al. Intraductal ultrasound for the evaluation of patients with biliary strictures and no abdominal mass on computed tomography. Endoscopy. 2005; 37: 715-721.Kapoor V., McCook B.M., Torok F.S. An introduction to PET-CT imaging. Radiographics. 2004; 24: 523-543.Kapoor V., McCook B.M., Torok F.S. An introduction to PET-CT imaging. Radiographics. 2004; 24: 523-543.Iglehart J.K. The new era of medical imaging - progress and pitfalls. N. Engl. J. Med. 2006; 354: 2822-2828.Iglehart J.K. The new era of medical imaging - progress and pitfalls. N. Engl. J. Med. 2006; 354: 2822-2828.Wakabayashi H., Akamoto S., Yachida S. et al. Significance of fluorodeoxyglucose PET imaging in the diagnosis of malignancies in patients with biliary stricture. Eur. J. Surg. Oncol. 2005; 31: 1175-1179.Wakabayashi H., Akamoto S., Yachida S. et al. Significance of fluorodeoxyglucose PET imaging in the diagnosis of malignancies in patients with biliary stricture. Eur. J. Surg. Oncol. 2005; 31: 1175-1179.Anderson C.D., Rice M.H., Pinson C.W. et al. Fluorodeoxyglucose PET imaging in the evaluation of gallbladder carcinoma and cholangiocarcinoma. J. Gastrointest. Surg. 2004; 8: 90-97.Anderson C.D., Rice M.H., Pinson C.W. et al. Fluorodeoxyglucose PET imaging in the evaluation of gallbladder carcinoma and cholangiocarcinoma. J. Gastrointest. Surg. 2004; 8: 90-97.Lan B.Y., Kwee S.A., Wong L.L. Positron emission tomography in hepatobiliary and pancreatic malignancies: a review. Am. J. Surg. 2012; 204 (2): 232-241.Lan B.Y., Kwee S.A., Wong L.L. Positron emission tomography in hepatobiliary and pancreatic malignancies: a review. Am. J. Surg. 2012; 204 (2): 232-241.Li J., Kuehl H., Grabellus F. et al. Preoperative assessment of hilar cholangiocarcinoma by dual-modality PET/CT. J. Surg. Oncol. 2008; 98: 438-443.Li J., Kuehl H., Grabellus F. et al. Preoperative assessment of hilar cholangiocarcinoma by dual-modality PET/CT. J. Surg. Oncol. 2008; 98: 438-443.Petrowsky H., Wildbrett P., Husarik D.B. et al. Impact of integrated positron emission tomography and computed tomography on staging and management of gallbladder cancer and cholangiocarcinoma. J. Hepatol. 2006; 45: 43-50.Petrowsky H., Wildbrett P., Husarik D.B. et al. Impact of integrated positron emission tomography and computed tomography on staging and management of gallbladder cancer and cholangiocarcinoma. J. Hepatol. 2006; 45: 43-50.Chikamoto A., Tsuji T., Takamori H. et al. The diagnostic efficacy of FDG-PET in the local recurrence of hilar bile duct cancer. J. Hepatobil. Pancreat. Surg. 2006; 13: 403-408.Chikamoto A., Tsuji T., Takamori H. et al. The diagnostic efficacy of FDG-PET in the local recurrence of hilar bile duct cancer. J. Hepatobil. Pancreat. Surg. 2006; 13: 403-408.Brock K.K. Imaging and image-guided radiation therapy in liver cancer. Semin. Radiat. Oncol. 2011; 21(4): 247-255.Brock K.K. Imaging and image-guided radiation therapy in liver cancer. Semin. Radiat. Oncol. 2011; 21(4): 247-255.Rimola J., Forner A., Reig M. et al. Cholangiocarcinoma in cirrhosis: absence of contrast washout in delayed phases by magnetic resonance imaging avoids misdiagnosis of hepatocellular carcinoma. Hepatology. 2009; 50: 791-798.Rimola J., Forner A., Reig M. et al. Cholangiocarcinoma in cirrhosis: absence of contrast washout in delayed phases by magnetic resonance imaging avoids misdiagnosis of hepatocellular carcinoma. Hepatology. 2009; 50: 791-798.Corvera C.U., Blumgart L.H., Akhurst T. et al. 18F-fluorodeoxyglucose positron emission tomography influences management decisions in patients with biliary cancer. J. Am. Coll. Surg. 2008; 206: 57-65.Corvera C.U., Blumgart L.H., Akhurst T. et al. 18F-fluorodeoxyglucose positron emission tomography influences management decisions in patients with biliary cancer. J. Am. Coll. Surg. 2008; 206: 57-65.Moon C.M., Bang S., Chung J.B. et al. Usefulness of 18F-fluorodeoxyglucose positron emission tomography in differential diagnosis and staging of cholangiocarcinomas. J. Gastroenterol. Hepatol. 2008; 23 (5): 759-765.Moon C.M., Bang S., Chung J.B. et al. Usefulness of 18F-fluorodeoxyglucose positron emission tomography in differential diagnosis and staging of cholangiocarcinomas. J. Gastroenterol. Hepatol. 2008; 23 (5): 759-765.Xu J., Igarashi S., Sasaki M. et al. Intrahepatic cholangiocarcinomas in cirrhosis are hypervascular in comparison with those in normal livers. Liver Int. 2012; 32 (7): 1156-1164.Xu J., Igarashi S., Sasaki M. et al. Intrahepatic cholangiocarcinomas in cirrhosis are hypervascular in comparison with those in normal livers. Liver Int. 2012; 32 (7): 1156-1164.Савельева Т.В., Кащенко В.А. Возможности многослойной спиральной компьютерной томографии в выявлении опухолевых поражений внепеченочных желчных протоков. Луч. диагн. и тер. 2010; 3: 54-60.Савельева Т.В., Кащенко В.А. Возможности многослойной спиральной компьютерной томографии в выявлении опухолевых поражений внепеченочных желчных протоков. Луч. диагн. и тер. 2010; 3: 54-60.Valls C., Ruiz S., Martinez L. et al. Radiological diagnosis and staging of hilar cholangiocarcinoma. Wld J. Gastrointest. Oncol. 2013; 5 (7): 115-126.Valls C., Ruiz S., Martinez L. et al. Radiological diagnosis and staging of hilar cholangiocarcinoma. Wld J. Gastrointest. Oncol. 2013; 5 (7): 115-126.Aloia T.A., Charnsangavej C., Faria S. et al. High-resolution computed tomography accurately predicts resectability in hilar cholangiocarcinoma. Am. J. Surg. 2007; 193: 702-706.Aloia T.A., Charnsangavej C., Faria S. et al. High-resolution computed tomography accurately predicts resectability in hilar cholangiocarcinoma. Am. J. Surg. 2007; 193: 702-706.Ustundag Y., Bayraktar Y. Cholangiocarcinoma: a compact review of the literature. Wld J. Gastroenterol. 2008; 14 (42): 6458-6466.Ustundag Y., Bayraktar Y. Cholangiocarcinoma: a compact review of the literature. Wld J. Gastroenterol. 2008; 14 (42): 6458-6466.Murakami K. FDG-PET for hepatobiliary and pancreatic cancer: Advances and current limitations.Wld. J. Clin. Oncol. 2011; 2 (5): 229-236.Murakami K. FDG-PET for hepatobiliary and pancreatic cancer: Advances and current limitations.Wld. J. Clin. Oncol. 2011; 2 (5): 229-236.Vogl T.J., Schwarz W.O., Heller M. et al. Staging of Klatskin tumours (hilar cholangiocarcinomas): comparison of MR cholangiography, MR imaging, and endoscopic retrograde cholangiography. Eur. Radiol. 2006; 16: 2317-2325.Vogl T.J., Schwarz W.O., Heller M. et al. Staging of Klatskin tumours (hilar cholangiocarcinomas): comparison of MR cholangiography, MR imaging, and endoscopic retrograde cholangiography. Eur. Radiol. 2006; 16: 2317-2325.Manfredi R., Barbaro B., Masselli G. et al. Magnetic resonance imaging of cholangiocarcinoma. Semin. Liver. Dis. 2004; 24: 155-164.Manfredi R., Barbaro B., Masselli G. et al. Magnetic resonance imaging of cholangiocarcinoma. Semin. Liver. Dis. 2004; 24: 155-164.Гришина Е.В. Магнитно-резонансная холангиопанкреатография в диагностике патологии гепатопанкреатодуоденальной области: Автореф.. дис. канд. мед. наук. М., 2004. 22 с.Гришина Е.В. Магнитно-резонансная холангиопанкреатография в диагностике патологии гепатопанкреатодуоденальной области: Автореф.. дис. канд. мед. наук. М., 2004. 22 с.Fernandez-Esparrach G., Gines A., Sanchez M. et al. Comparison of endoscopic ultrasonography and magnetic resonance cholangiopancreatography in the diagnosis of pancreatobiliary diseases: a prospective study. Am. J. Gastroenterol. 2007; 102: 1632-1639.Fernandez-Esparrach G., Gines A., Sanchez M. et al. Comparison of endoscopic ultrasonography and magnetic resonance cholangiopancreatography in the diagnosis of pancreatobiliary diseases: a prospective study. Am. J. Gastroenterol. 2007; 102: 1632-1639.Sai J.K., Suyama M., Kubokawa Y. et al. Early detection of extrahepatic bile-duct carcinomas in the nonicteric stage by using MRCP followed by EUS. Gastrointest. Endosc. 2009; 70: 29-36.Sai J.K., Suyama M., Kubokawa Y. et al. Early detection of extrahepatic bile-duct carcinomas in the nonicteric stage by using MRCP followed by EUS. Gastrointest. Endosc. 2009; 70: 29-36.Ruys A.T., van Beem B.E., Engelbrecht M.R. et al. Radiological staging in patients with hilar cholangiocarcinoma: a systematic review and meta-analysis. Br. J. Radiol. 2012; 85: 1255-1262.Ruys A.T., van Beem B.E., Engelbrecht M.R. et al. Radiological staging in patients with hilar cholangiocarcinoma: a systematic review and meta-analysis. Br. J. Radiol. 2012; 85: 1255-1262.Sacks A., Peller P.J., Surasi D.S. et al. Value of PET/CT in the Management of Liver Metastases, Part 2. Am. J. Roentgenol. 2011; 197: W256-W259.Sacks A., Peller P.J., Surasi D.S. et al. Value of PET/CT in the Management of Liver Metastases, Part 2. Am. J. Roentgenol. 2011; 197: W256-W259.Iwaki K., Shibata K., Ohta M. et al. Adenomyomatous hyperplasia of the common bile duct: report of a case. Surg. Today. 2008; 38: 85-89.Iwaki K., Shibata K., Ohta M. et al. Adenomyomatous hyperplasia of the common bile duct: report of a case. Surg. Today. 2008; 38: 85-89.Gamblin T.C., Krasinskas A.M., Slivka A.S. et al. Fibroinflammatory biliary stricture: a rare bile duct lesion masquerading as cholangiocarcinoma. J. Gastrointest. Surg. 2009; 13: 713-721.Gamblin T.C., Krasinskas A.M., Slivka A.S. et al. Fibroinflammatory biliary stricture: a rare bile duct lesion masquerading as cholangiocarcinoma. J. Gastrointest. Surg. 2009; 13: 713-721.Pavey D.A., Gress F.G. The role of EUS-guided FNA for the evaluation of biliary strictures. Gastrointest. Endosc. 2006; 64: 334-337.Pavey D.A., Gress F.G. The role of EUS-guided FNA for the evaluation of biliary strictures. Gastrointest. Endosc. 2006; 64: 334-337.Pollack M.J., Gholam P.M., Chak A. EUS-FNA in unresectable cholangiocarcinoma: a novel indication. Gastrointest. Endosc. 2008; 67: 444-445.Pollack M.J., Gholam P.M., Chak A. EUS-FNA in unresectable cholangiocarcinoma: a novel indication. Gastrointest. Endosc. 2008; 67: 444-445.DeWitt J., Misra V.L., Leblanc J.K. et al. EUS-guided FNA of proximal biliary strictures after negative ERCP brush cytology results. Gastrointest. Endosc. 2006; 64: 325-333.DeWitt J., Misra V.L., Leblanc J.K. et al. EUS-guided FNA of proximal biliary strictures after negative ERCP brush cytology results. Gastrointest. Endosc. 2006; 64: 325-333.Бурдюков М.С., Нечипай А.М., Юричев И.Н. и др. Тонкоигольная пункция под контролем эндоскопической ультрасонографии в диагностике опухолей билиопанкреатодуоденальной зоны. Анн. хир. гепатол. 2010; 2: 66-71.Бурдюков М.С., Нечипай А.М., Юричев И.Н. и др. Тонкоигольная пункция под контролем эндоскопической ультрасонографии в диагностике опухолей билиопанкреатодуоденальной зоны. Анн. хир. гепатол. 2010; 2: 66-71.Weber A., Schmid R.M., Prinz C. Diagnostic approaches for cholangiocarcinoma. Wld J. Gastroenterol. 2008; 14 (26): 4131-4136.Weber A., Schmid R.M., Prinz C. Diagnostic approaches for cholangiocarcinoma. Wld J. Gastroenterol. 2008; 14 (26): 4131-4136.Victor D.W., Sherman S., Karakan T. et al. Current endoscopic approach to indeterminate biliary strictures. Wld J. Gastroenterol. 2012; 18 (43): 6197-6205.Victor D.W., Sherman S., Karakan T. et al. Current endoscopic approach to indeterminate biliary strictures. Wld J. Gastroenterol. 2012; 18 (43): 6197-6205.Yamao K., Bhatia V., Mizuno N. et al. EUS-guided choledochoduodenostomy for palliative biliary drainage in patients with malignant biliary obstruction: results of long-term follow-up. Endoscopy. 2008; 40 (4): 340-342.Yamao K., Bhatia V., Mizuno N. et al. EUS-guided choledochoduodenostomy for palliative biliary drainage in patients with malignant biliary obstruction: results of long-term follow-up. Endoscopy. 2008; 40 (4): 340-342.Saifuku Y., Yamagata M., Koike T. et al. Endoscopic ultrasonography can diagnose distal biliary strictures without a mass on computed tomography. Wld J. Gastroenterol. 2010; 16: 237-244.Saifuku Y., Yamagata M., Koike T. et al. Endoscopic ultrasonography can diagnose distal biliary strictures without a mass on computed tomography. Wld J. Gastroenterol. 2010; 16: 237-244.Kim H.M., Park J.Y., Kim K.S. et al. Intraductal ultrasonography combined with percutaneous transhepatic cholangioscopy for the preoperative evaluation of longitudinal tumor extent in hilar cholangiocarcinoma. J. Gastroenterol. Hepatol. 2010; 25: 286-292.Kim H.M., Park J.Y., Kim K.S. et al. Intraductal ultrasonography combined with percutaneous transhepatic cholangioscopy for the preoperative evaluation of longitudinal tumor extent in hilar cholangiocarcinoma. J. Gastroenterol. Hepatol. 2010; 25: 286-292.Inoue H. Diagnosis of Cancer Spread Using Percutaneous Transhepatic Biliary Cholangioscopy-guided Ultrasonography for Malignant Bile Duct Stenosis. Diagn. Ther Endosc. 2001; 7: 159-164.Inoue H. Diagnosis of Cancer Spread Using Percutaneous Transhepatic Biliary Cholangioscopy-guided Ultrasonography for Malignant Bile Duct Stenosis. Diagn. Ther Endosc. 2001; 7: 159-164.Fujita N., Noda Y., Kobayashi G. et al. Staging of bile duct carcinoma by EUS and IDUS. Endoscopy. 1998; 30, Suppl. 1: A132-A134.Fujita N., Noda Y., Kobayashi G. et al. Staging of bile duct carcinoma by EUS and IDUS. Endoscopy. 1998; 30, Suppl. 1: A132-A134.Duda S.H., Huppert P.E., Schott U. et al. Percutaneous transhepatic intraductal biliary sonography for lymph node staging at 12.5 MHz in malignant bile duct obstruction: work in progress. Cardiovasc. Intervent. Radiol. 1997; 20: 133-138.Duda S.H., Huppert P.E., Schott U. et al. Percutaneous transhepatic intraductal biliary sonography for lymph node staging at 12.5 MHz in malignant bile duct obstruction: work in progress. Cardiovasc. Intervent. Radiol. 1997; 20: 133-138.Malhi H., Gores G.J. Cholangiocarcinoma: modern advances in understanding a deadly old disease. J. Hepatol. 2006; 45: 856-867.Malhi H., Gores G.J. Cholangiocarcinoma: modern advances in understanding a deadly old disease. J. Hepatol. 2006; 45: 856-867.Shen W.F., Zhong W., Xu F. et al. Clinicopathological and prognostic analysis of 429 patients with intrahepatic cholangiocarcinoma. Wld J. Gastroenterol. 2009; 15 (47): 5976-5982.Shen W.F., Zhong W., Xu F. et al. Clinicopathological and prognostic analysis of 429 patients with intrahepatic cholangiocarcinoma. Wld J. Gastroenterol. 2009; 15 (47): 5976-5982.Gores G.J., Nagorney D.M., Rosen C.B. Cholangiocarcinoma: Is transplantation an option? For whom? J. Hepatol. 2007; 47: 455-459.Gores G.J., Nagorney D.M., Rosen C.B. Cholangiocarcinoma: Is transplantation an option? For whom? J. Hepatol. 2007; 47: 455-459.Вишневский В.А., Ефанов М.Г., Икрамов Р.З. и др. Отдаленные результаты радикальных и условно радикальных резекций при воротной холангиокарциноме. Анн. хир. гепатол. 2013; 2: 9-20.Вишневский В.А., Ефанов М.Г., Икрамов Р.З. и др. Отдаленные результаты радикальных и условно радикальных резекций при воротной холангиокарциноме. Анн. хир. гепатол. 2013; 2: 9-20.Meza-Junco J., Montano-Loza A.J., Ma M. et al. Cholangiocarcinoma: has there been any progress? Can. J. Gastroenterol. 2010; 24 (1): 52-57.Meza-Junco J., Montano-Loza A.J., Ma M. et al. Cholangiocarcinoma: has there been any progress? Can. J. Gastroenterol. 2010; 24 (1): 52-57.

The authors declare that there are no conflicts of interest present.