What is cholangiocarcinoma?
Cholangiocarcinoma means cancer of the bile ducts. This can arise from bile ducts inside the liver or outside of the liver. It can also grow large enough to involves surrounding structures including the arteries and veins.
What causes bile duct cancer?
The exact cause of plunger carcinoma is not known and remain a mystery in most patients. There are risk factors that predisposed to bile duct cancer through a common pathway of chronic bile duct irritation. This can be from a choledochal cyst, recurrent infections, and autoimmune diseases. There's also an association with ulcerative colitis in patients that have primaries sclerosing cholangitis (PSC).
What are symptoms of bile duct cancer?
The role of the bile ducts is to collect bile from the liver cells and deliver them to the small intestine. With bile duct cancer, the patient may experience symptoms such as:
- Jaundice (yellowing of the skin)
- Dark urine
- Pale stools
- Itchy skin
What are the treatment options for bile duct cancer?
The location of the cancer determines the treatment options. If the tumor is localized to the liver, then it can be resected without requiring a reconstruction of the bile ducts. This carries a lower risk and a quicker recovery.
If the tumor involves the bile duct confluence, then a bile duct reconstruction will be required. This usually requires a liver resection in addition to the bile duct resection to achieve clear margins.
If the bile duct tumor is lower in the duct, then it will require combined pancreas head and bile duct resection. This is called a pancreaticoduodenectomy (Whipple procedure).
Surgery is the only therapy that can achieve cure; for those patients that are not resectable, the non-surgical options include chemotherapy and radiation.
For patients that have a tumor at the confluence of the bile ducts or have poor liver function such that, then a liver transplant may be considered.