Intraoperative Assessment of the Prevalence of Proximal Bile Duct Cancer by Optical Coherence Tomography
Aim. To define possibilities of the perioperative optical coherence tomography in determination of the Klatskin tumor borders. Material and methods. A novel tool of periperative optical coherence tomography by means of "OCT 1300-Y"device is firstly applied to determine the Klatskin tumor extent margins in 22 patients. The microstructure of all layers of the of bile ducts walls examined in real time in norm, inflammation, scar. Besides defined the boundary of the pathological process spread through the duct during surgery. After identifying and marking the boundaries of the tumor, bile duct resected with a margins not less than 5 mm. Results. According on the results of optical coherence tomography 22 patients underwent surgery. The significant tumor growth to segmental bile ducts, diagnosed by means of optical coherence tomography changed the extent of resection in 4 cases. The study of follow up results in a period of 6 months to 4 years allowed to establish absence of local tumor recurrence. Conclusions. Prioperative real time optical coherence tomography makes possible to determine Klatskin tumor spread boundaries, allows to choose necessary volume of operation and to guarantee curative (R0) surgery.