Bile Duct Cancer (Cholangiocarcinoma)

Cancer of the biliary tract (gallbladder and bile ducts) usually does not produce symptoms in its earliest stages. Typically, patients develop jaundice (yellowing of the skin and whites of the eyes), which causes them to see their doctor. Other symptoms can include an enlarged gallbladder, itching, dark urine, loss of weight or loss of appetite, light-colored stool and fever.

Diagnosis is made by ultrasound (a painless procedure in which the doctor uses sound waves to look at the gallbladder and bile ducts), CT scan (a painless X-ray), MRI (a type of imaging using a large magnet), cholangiogram (an X-ray of the bile ducts using a long, flexible tube inserted into the mouth, through the stomach and bile ducts, which releases dye), PET scans and fine-needle aspiration (in which a small needle is inserted through the abdomen into the bile ducts to remove a small sample of the tumor for biopsy).

Treatment varies depending on how far the cancer has advanced and the size of the tumor. It may include surgery, liver transplant, chemotherapy, radiation or other treatments. For very small tumors, the surgeon may remove a part of the bile duct that is cancerous. If the cancer has advanced, nearby liver tissue and/or lymph nodes also may be removed.

Liver transplant can be an option for those patients whose bile duct tumors have not spread outside of the liver, but that cannot be removed.

Prognosis depends on how early the cancer is caught, the patient’s overall health and how well the liver and ducts are functioning.

Washington University hepatobiliary-pancreatic & gastrointestinal (HPB-GI) surgeons are part of a multi-disciplinary team at Siteman Cancer Center who treat cancer of the liver or biliary tract. Siteman is the only cancer center in Missouri to hold the prestigious Comprehensive Cancer Center designation from the National Cancer Institute and membership in the National Comprehensive Cancer Network.

See Siteman Cancer Center treatment approach.

Washington University HPB-GI surgeons who treat bile duct cancer:

William G. Hawkins, MD, Section Chief

Maria B. Majella Doyle, MD

Ryan C. Fields, MD

Chet Hammill, MD, MCR

Adeel Khan, MD, MPH

Steven M. Strasberg, MD

 

Siteman Cancer Center locations for HPB-GI surgeons:

Main campus (St. Louis)

South County campus

West County campus