Endoscopic management of cholangiocarcinoma

Cholangiocarcinoma (CCA) is the most frequent and aggressive malignant tumor of the biliary tract. Endoscopic management has evolved in recent years and has come to hold a vital role in the management of CCA. Classically, the endoscopic approach was limited to palliative procedures for draining the biliary tract. With the development and use of new techniques such as cholangioscopy, endoscopy can not only facilitate early detection of CCA but also offers the possibility of novel therapies such as radiofrequency and photodynamic therapy that can improve quality of life and mortality. In this chapter we describe old and new endoscopic techniques with some perspectives regarding future developments in the field and the enduring need to help improve survival associated with this aggressive malignancy.