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Bile duct cancer (RDF) is a malignant tumor that arises in the epithelium lining the lumen of the bile ducts and the gallbladder. It can develop in the intrahepatic as well as extrahepatic bile ducts. What are the causes of bile duct cancer? Bile duct cancer symptoms and treatment.

Bile duct canceriscancer , which accounts for 15 to 20 percent of all liver cancer cases. Every year, it is detected in approximately 100,000 patients worldwide. Unfortunately, it is usually diagnosed late and the prognosis is usually poor.

Bile duct cancer: symptoms

In the initial stage, bile duct cancer has little characteristic symptoms, which means that it is diagnosed late and worsens the prognosis.

  • jaundice - occurs in about 90 percent of patients, it indicates the advancement of the neoplastic process - obstruction of the bile duct and the presence of difficulties in the flow of bile into the duodenum
  • itchy skin - occurs in about 2/3 percent of patients
  • abdominal pain - dull, constant, located in the right hypochondrium, occurs when the cancer is located in the intrahepatic tract
  • lose weight

A physician on physical examination may sometimes find an enlarged liver or, occasionally, a very rarely palpable tumor in the right hypochondrium. When the cancer is located in the bile ducts close to the duodenal mouth, the examination can detect an enlarged, painless gallbladder - it is called Courvoisier symptom.

Bile duct cancer: diagnosis

In blood tests you can see:

  • elevated bilirubin
  • increased levels of liver enzymes: ALP, ALAT, AST, GGTP
  • higher concentration of tumor markers: CEA and CA19-9

Imaging test results:

  • USG allows to assess biliary dilatation, if there are no gallstones, it suggests a tumor
  • Computed tomography allows to assess the tumor advancement, metastases and the extent of infiltration
  • MRCP allows you to assess the narrowing and dilatation of the bile ducts and the extent of the tumor itself

Ultimatethe diagnosis is made on the basis of the results of the histopathological examination.

Bile duct cancer: prognosis

The prognosis for cancer of the bile ducts (ducts) is very poor. The time of survival from diagnosis differs depending on the location of the tumor:

  • intrahepatic localization - the time of survival after diagnosis does not exceed 30 months, and often it is not more than 12 months
  • extrahepatic localization - five-year survival after diagnosis is 20-30 percent

Bile duct cancer: treatment

The only treatment that gives a chance of recovery is surgery.

  • In the case of cancer of the intrahepatic bile ducts, hemihepatectomy is performed - the liver segments are removed.
  • In the case of extrahepatic bile duct cancer, the bile ducts and surrounding lymph nodes are removed.
  • If the bile duct near its exit to the duodenum is involved, pancreatoduodenectomy is performed (removal of the duodenum, common bile duct and pancreatic head with appropriate anastomosis).

After the surgery, sometimes radiotherapy and / or chemotherapy are used, but no increase in the survival time of patients treated in this way was noticed.

In the case of patients whose cancer stage precludes surgery, palliative treatment is used to improve the patient's quality of life and alleviate the symptoms of the disease: pain, jaundice and itching of the skin. Painkillers (including narcotic drugs) are used. To facilitate the outflow of bile, the bile ducts are drained.

Bile duct cancer: risk factors

  • primary sclerosing cholangitis (PSC) - the incidence of this cancer in patients with PSC is much higher than in the general population
  • ulcerative colitis
  • biliary cysts
  • cholelithiasis secondary to chronic cholangitis - patients with these diseases should be under the constant supervision of the gastroenterology clinic.

Patients who belong to the risk groups should be recommended periodically to undergo blood tests and ultrasound of the abdominal cavity in order to detect the disease early.

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Category:

Oncology