Bile duct (bile duct) cancer: What you need to know

This article was written by doctors of Internal Oncology Department, Vinmec Times City International General Hospital.

Bile duct cancer, also known as cholangiocarcinoma, is a rare type of cancer, mainly seen in people over the age of 65. Bile ducts are small tubes that connect the liver and small intestine. They allow a fluid called bile to flow from the liver, through the pancreas, to the intestines, helping with the digestion of food.

Bile duct cancer arises from the cells lining the bile ducts, the drainage system for bile produced by the liver. The bile ducts collect bile, drain it into the gallbladder and eventually into the small intestine, aiding the digestive process. Bile duct cancer is also known as cholangiocarcinoma.
Bile duct cancer is a rare form of cancer, with about 2,500 new cases diagnosed in the United States each year. There are three general sites where this cancer can arise in the bile drainage system:
Intrahepatic biliary tract: Affects bile ducts located in the liver; Just outside the liver: Located in the groove of the liver where the bile ducts exit; Far outside the liver: Near where the bile duct enters the intestine. Bile duct cancer is usually found just outside the liver and least commonly inside the liver.
The incidence of cholangiocarcinoma increases with age. This is a slow-growing cancer that invades internal structures, so diagnosis is often delayed until the bile ducts have become blocked. This obstruction prevents bile from draining from the liver into the gallbladder and intestines. Depending on where the blockage occurs, this can lead to hepatitis and/or pancreatitis.
Chronic inflammation of the bile ducts may be a risk factor for cancer. Diseases that cause chronic inflammation include primary sclerosing cholangitis (especially when associated with ulcerative colitis), chronic liver disease, including hepatitis B, hepatitis C, and chronic hepatitis alcohol and cirrhosis.

Some parasitic infections that cause liver infections may also increase the risk.
Gallstones are not a risk factor for developing bile duct cancer, but stones in the liver increase the risk. Liver stones are quite common in Asian countries.
There are rare congenital diseases that increase the risk of bile duct cancer, including Lynch syndrome II (inherited colorectal cancer associated with biliary tree and other cancers) and Caroli syndrome ( hypertension, cirrhosis, and biliary cysts).

The initial symptoms of cholangiocarcinoma occur due to the inability to drain bile from the liver where bile is produced. This causes hepatitis. Cholangiocarcinoma symptoms include yellowing of the eyes, itching, abdominal pain, bloating, and weight loss. Fever is mild, and urine and stools may be dark in color.
Bile duct tumors may not cause any symptoms until they have grown in size and the cancer has spread beyond the original site. Abdominal pain is usually a late symptom and is usually located in the upper right quadrant of the abdomen, and the liver may be tender and enlarged.

Taking the medical history and examining the patient are clues to the diagnosis of bile duct cancer. Painless jaundice (yellow/orange coloration of the skin and eyes) may be the only symptom. History of alcohol, drug use, or recent illnesses may be associated with hepatitis or inflammation. Other cholangiocarcinoma symptoms may include weight loss, loss of appetite, weakness, loss of energy, and easy bruising or bleeding (loss of liver function can reduce clotting factors in the blood).
Patients often have pain in the abdomen on examination, especially in the upper right quadrant below the ribs. One-quarter of patients with bile duct cancer will have an enlarged liver that can be palpated or felt on examination. On physical examination, the patient usually has jaundice, a yellowish tan, which can be most easily seen on the white part of the eye or under the tongue.
Blood tests are usually done to evaluate liver function. Liver enzymes (AST, ALT, GGT, alkaline phosphatase), bilirubin levels, complete blood count, electrolytes, bilirubin and creatinine, blood clotting tests such as INR/PTT (normalized ratio). international/partial thromboplastin time) and PT (prothrombin time).
No blood test can accurately diagnose cholangiocarcinoma. Diagnosis is confirmed by tissue samples obtained by biopsy.

Imaging tests may be used to evaluate the structure of the liver, gallbladder, bile ducts, and other surrounding organs. Tests such as ultrasound, CT scan, and magnetic resonance imaging may be done to look for a tumor and assess how far it has spread.
The danger of liver cancer has shown the importance of screening and early detection of the disease. Therefore, Vinmec International General Hospital has provided customers with a package of screening and early detection of liver cancer to screen for liver cancer for people at high risk of diseases such as: alcoholics, cirrhosis, family history of liver cancer, cirrhosis, hepatitis B virus infection, chronic hepatitis C,...
Service selection Package for screening and early detection of liver cancer, patients will be examined, consulted and performed tests, diagnostic imaging to evaluate liver function, liver diseases and liver cancer screening.
Customers can directly go to Vinmec Health system nationwide to visit or contact the hotline here for support.

MORE:
Role of ALT and AST in the diagnosis of liver diseases What does Bilirubin say about your health? Common types of liver cancer