How is the tx of cholangiocarcinoma?

Surgery (recurrence high 62%, 5 year survival low (22-42%) R0 resection is for 63% of pt and get higher 5 year survival (40-60%) Surgery morbidity (35%) and mortality (5%) No result of chemo (neo or adjuvant) Liver transplant not recommended (0% 5-year survival) Whipple resection for distal extrahepatic. Pt w/PSC and perihilar cholangio should consider liver transplant instead of resection (since low resectability) Can restore biliary drainage by endoscopic/percutaneous stents/ surgical. Photoynamic therapy (PDT) paliative tx of cholestasis survival similar to R1/R2 resection.