What is bile duct cancer (cholangiocarcinoma)?
Small tributaries join together to form right and left hepatic duct from right and left side of liver. Right and left duct join just outside the liver to form common hepatic duct. Gallbladder duct joins the common hepatic duct to form common bile duct(CBD). CBD drains the liver juice /bile into duodenum, just before entering the duodenum CBD is joined for short distance by pancreatic duct.Bile duct cancer can arise in any of its part. Mainly divided into intahepatic and extrahepatic.
Symptoms
- Obstructive Jaundice
- Abdominal pain
- Weight loss
- Fever
- Anorexia
- Pruritis.
Tests
- LFT- to ascertain jaundice and level of jaundice
- Tumour marker CA19-9, CEA raised level of tumour marker is suggestive of tumour though not confirmatory.
- Ultra sound abdomen is the intial scan which gives an idea about the tumour site.
- Triphasic CT scan Abomen- Show the site of the tumour, its local spread, involvement of the vasculature.
- MRI is another useful scan that yields information similar to CT, but also gives three-dimensional reconstruction of the bile ducts (called MRCP). This can provide a roadmap for the biliary anatomy above and below the tumour.
- PET scanning can detect cholangiocarcinoma as well as the presence of distant spread, but its use is not routine.
- EUS (endoscopic ultrasound) increasingly plays a role in the diagnosis of cholangiocarcinoma and can also guide fine needle aspiration of a cell sample.
