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Digestive system
Digestive system
Bile pathway
Bile pathway

Cholangiocarcinoma
Definition:
Cholangiocarcinoma is a malignant (cancerous) growth in one of the ducts that carries bile from the liver to the small intestine.

Alternative Names:
Bile duct cancer

Causes, incidence, and risk factors:

Malignant tumors of the bile ducts are usually slow growing and late to spread (metastasize). Nonetheless, by the time a diagnosis is made, many of these tumors are too advanced to be removed surgically.

A cholangiocarcinoma can arise anywhere along the liver secretion (biliary) ducts. These tumors produce symptoms by blocking the bile ducts. They affect both sexes, and a majority of cases are found in patients above the age of 65.

Primary sclerosing cholangitis, choledochal (bile duct) cysts, and chronic biliary irritation are all associated with increased risk for this condition. Cholangiocarcinoma is rare, occurring in approximately 2 out of 100,000 people.
Symptoms:
Signs and tests:
Tests that show tumor or obstruction in the bile duct:Blood tests that reveal abnormal function:
Treatment:

The goal is to treat the cancer and the obstruction it causes. When possible, surgical removal of the tumor is the treatment of choice and may result in cure. Chemotherapy or radiation may be given after surgery to decrease the risk of recurrence, but the benefit of this is not entirely clear.

Endoscopic therapy or surgery can clear obstructions in the biliary ducts and relieve jaundice in patients in whom the tumor is unresectable (cannot be removed).

For patients with unresectable disease, radiation therapy may be beneficial. Chemotherapy may be added to radiation therapy or used when tumor has spread outside of the biliary tree; however, it is rarely effective.
Support Groups:
The stress of illness can often be helped by joining a support group where members share common experiences and problems. For this condition, see cancer - support group. Hospice is often a good resource for patients with cholangiocarcinoma that cannot be cured.
Expectations (prognosis):
Complete tumor removal allows 30% to 40% of patients to survive for at least 5 years, with the possibility of a complete cure. If the tumor cannot be completely removed, cure is generally not possible. In this situation, with treatment, about half of patients live a year, and about half live longer.
Complications:
Calling your health care provider:
Call your health care provider if persistent jaundice or other symptoms of cholangiocarcinoma are present.
Review Date: 8/25/2002
Reviewed By: Scott Howard, M.D., M.S., Memphis, TN. Review provided by VeriMed Healthcare Network.
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