Cholangiocarcinoma (Bile Duct Cancer)

Diagnosing Cholangiocarcinoma

Symptoms of cholangiocarcinoma

Symptoms of a bile duct tumor are similar to those of hepatocellular carcinoma (HCC), or advanced primary liver cancer, and may include:

• Abdominal pain
• Abdominal swelling or mass
• Fatigue
• Fluid in the abdomen
• New onset jaundice (yellowish coloring of the skin that results from excess bile)
• Weight loss

Testing for cholangiocarcinoma

In addition to a physical exam, your doctor may order several tests to evaluate:

• The extent and location of the tumor
• The tumor's proximity to major hepatic (liver) blood vessels
• Whether the tumor is spreading
• The quality of liver function

These tests may include:

Imaging studies

A CT scan may show a dilated bile duct, indicating the presence of a tumor.

Blood tests

Blood tests will measure bilirubin levels to help determine whether a tumor is blocking the bile duct.

Bilirubin is the product responsible for the yellow color of bile and urine.

If tests indicate increased bilirubin and duct obstruction, specialists may place a stent, or tube, in the duct to relieve the blockage. As a result of this procedure, bilirubin levels should return to normal.

Biopsy

People who have abdominal pain might have an exam of the gastrointestinal tract, called endoscopic retrograde cholangiopancreatography (ERCP).

This test helps the doctor detect a narrowing of the duct, which could indicate the presence of a tumor.

If ERCP confirms the existence of a tumor, the doctor may use a brush to take a tissue sample during the procedure. The sample will undergo a biopsy to test for cancer.

Other tests

Other tests may include:

• Angiogram — determines blood vessel involvement and blood flow to the tumor.
• Cholangiography— uses x-rays and a large needle inserted into the liver to examine the gallbladder and bile ducts.
• MRI cholangiogram — inspects the duct that connects the liver to the small intestine.

Cholangiocarcinoma Treatment

The UPMC Liver Cancer Center offers several treatment options for people with cholangiocarcinoma.

Liver surgery (resection)

Depending on the size and location of your tumor, and the general health of your liver, you may be a candidate for surgical removal of the tumor(s).

Surgery, either minimally invasive (laparoscopic) liver surgery or traditional (open) liver surgery, offers the best chance for cure or long-term survival.

UPMC’s liver surgeons are among the most experienced in the United States at minimally invasive liver surgery, which is performed through three or four small incisions in the abdomen. We perform this technique whenever possible to reduce pain, scarring, and recovery time.

Therapies for bile duct cancer

If your tumor is too large to be removed by surgery, the UPMC Liver Cancer Center offers innovative therapies to:

• Help shrink the tumor so surgery is possible
• Manage your liver disease and extend your life