A NEW METHOD TO OBTAIN A TISSUE DIAGNOSIS OF PROXIMAL BILE-DUCT TUMORS

Klatskin tumors often pose a challenge for diagnosis and treatment. Mo st of these neoplasms are diagnosed clinically because of the difficul ty in obtaining tissue that will provide histologic proof of the disea se. When a nonoperative course is sought, exhaustive attempts should b e made to obtain a tissue diagnosis because of the potential for a fal se-positive clinical diagnosis. We describe a new way to obtain tissue for diagnosis by placing a laparoscopic choledochoscope through a per cutaneous transhepatic cholangiogram track, thus allowing the tumor to be directly visualized and biopsied.