bile duct cancer
The bile ducts are those that connect the liver to the intestine and their main function is the drainage of bile (which is a breakdown product of the normal functioning of liver cells).
Bile duct disease often results in a narrowing of the duct, called a stricture.
Strictures can be caused by:
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Scars (primary sclerosing cholangitis, secondary sclerosing cholangitis)
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Traumatic (usually surgical injury)
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By stones (lithos)
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Tumor (cancer and/or polyps)
Jaundice or changes in liver function tests are the most common reason for a doctor to suspect a problem with the liver or bile ducts.
bile duct cancer
Also called cholangiocarcinoma; It arises from the epithelium lining the bile ducts within the liver or in those ducts outside the liver.
Cholangiocarcinoma is difficult to cure and in most cases is sporadic with no identified cause.
Risk factors associated with cholangiocarcinoma include:
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Primary sclerosing cholangitis
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Ulcerative colitis
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Chronic cholestasis with chronic stone disease
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Congenital biliary cystic anomalies
staging
Staging is the process through which health professionals determine to which sites cancer may spread. It allows to identify which cancer remains in the bile ducts and which has migrated to the lymph nodes or to other parts of the body.
Current methods for staging cholangiocarcinoma
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Computed Axial Tomography (CT)
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Magnetic Resonance Imaging (MRI)
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Endoscopic Retrograde Cholangiopancreatography (ERCP)
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Endoscopic Ultrasound (EUS)
Each of these methods has advantages and limitations. Their combination makes it possible to select candidates for surgical treatment.
Treatment
Relief of biliary obstruction is the most appropriate therapeutic approach for most patients with cholangiocarcinoma. Stents are useful in providing adequate drainage of the bile ducts.
Two types of stents are used:
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Endoscopic stents (placement through an endoscope)
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Percutaneous stents (placement through the skin)
The best approach depends on the characteristics of each patient, location of the tumor and experience of the doctor.
Chemotherapy and transplant
Currently, the scientific evidence suggests a small survival advantage with the use of chemotherapy and radiation therapy.
Transplantation is not effective in terms of treatment due to rapid tumor recurrence and decreased survival.