Bile Duct Cancer

Note: The information on cancer types on the ACRF website is not designed to provide medical or professional advice and is for information only. If you have any health problems or questions please consult your doctor.

What is bile duct cancer?

The bile ducts are the tubes that take bile from the liver and pass it to the small bowel. Two bile ducts are connected to the liver and one is connected to the gallbladder. These three ducts join to form the common bile duct which then connects to the small bowel and meets the pancreatic duct.
Bile duct cancer can start anywhere along the bile ducts. It has different names depending on where it starts, and symptoms depend on where it grows.
Types of bile duct cancer
The different types of bile duct cancers include:
- Klatskin tumours: This cancer, also known as perihilar cancer, starts where the right hepatic duct joins the left hepatic duct.
- About 50 per cent of all bile duct cancers are Klatskin tumours.
- Intrahepatic bile duct cancers: This cancer begins in the bile ducts within the liver. These tumours are treated in the same way as a primary liver cancer.
- Common bile duct cancer: This cancer begins in the common bile duct.
  Multifocal bile duct cancer: This is the term used for when there is more than one tumour found in different locations within the bile ducts.
Bile duct cancer symptoms
Bile duct cancer symptoms can include:
- Jaundice (yellowing of the skin or whites of the eyes).
- Abdominal pain
- Fever
- Itchy skin
There are a number of conditions that may cause these symptoms, not just bile duct cancer. If any of these symptoms are experienced, it is important that they are discussed with a doctor.
Bile Duct Cancer Treatment
Diagnosing bile duct cancer
To successfully diagnose bile duct cancer several procedures may be used, including:
- Ultrasound exam, CT scan or MRI imaging
- Liver function tests
- Edoscopic retrograde cholangiopancreatography (ERC): A special procedure used to x-ray the bile ducts.
- Percutaneous transhepatic cholangiography(PTC): A procedure used to x-ray the liver and bile ducts.
- Biopsy: The removal of cells or tissues to be examined under microscope.
Bile duct cancer treatment
The two most common types of treatment for bile duct cancer are surgery and radiation therapy.
Types of surgery used to treat bile duct cancer will depend on the spread of the disease, and include:
- Removal of the bile duct: This surgery removes the entire bile duct if the tumour is small and has not spread. A new duct is then made by connecting the duct openings in the liver to the intestine.
- Whipple procedure: In this surgical procedure the head of the pancreas, the gallbladder, part of the stomach, part of the small intestine, and the bile duct are all removed. In most cases enough of the pancreas is left to make digestive juices and insulin.
- Surgical biliary bypass: If the tumour is blocking the small intestine and causing bile to build up in the gallbladder, but cannot be surgically removed, a biliary bypass may be done. During this operation, the gallbladder or bile duct will be cut and sewn to the small intestine to create a new pathway around the blocked area.
- Stent placement: If the tumour is blocking the bile duct, a stent (a thin tube) may be placed in the duct to drain bile that has built up in the area. The stent may drain to the outside of the body or it may go around the blocked area and drain the bile into the small intestine.