A patient with hepatolithiasis may develop cholangiocarcinoma. A number of clinical findings may identify a patient who should be evaluated for an occult cholangiocarcinoma.
Patient selection: hepatolithiasis
Outcome: cholangiocarcinoma
Clinical findings that may indicate the presence of an occult cholangiocarcinoma:
(1) duration of cholelithiasis-related symptoms > 10 years
(2) smoking
(3) unexplained weight loss
(4) family history of cancer
(5) failure to visualize portal veins on portograms
(6) elevated serum CEA concentration
(7) elevated serum alkaline phosphatase
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