A cholangiocarcinoma is a malignant tumor or cancer that arise from the cells lining the bile ducts in the biliary system. The biliary system contains the bile ducts and the gallbladder, a pouch-like organ that functions as a storage place for bile. Bile, a greenish-yellow liquid produced by the liver, is important in the digestion of fats, in vitamin absorption, and in carrying waste products down to the intestines. A growing cholangiocarcinoma often causes blockage or obstruction in the flow of bile through these ducts.
The bile ducts are tube-like structures where bile passes from the liver to the gallbladder and down into the intestines. Inside the liver, they are called intrahepatic ducts; when located just outside the liver, these ducts are called perihilar ducts. There is also the common bile duct, a larger duct formed by the union of the ducts coming from the gallbladder and the liver, which drains into the intestines. A majority of cholangiocarcinoma cases arise in the perihilar ducts. A small number also grow in the common bile duct and in the intrahepatic ducts.
Patients with cholangiocarcinoma frequently complain of non-specific symptoms such as fever, chills, loss of appetite, and pain, usually occurring at the right section of the abdomen. Other symptoms commonly seen in cholangiocarcinoma patients include passing of clay-colored stools, itching, and jaundice or yellowing of the skin and eyes. Clay-colored stools are often seen in these patients because bile is generally the substance that gives the brown color to stools. When the flow of bile is blocked, it stays in the circulation, often resulting in the yellowing of the skin. As bile also deposits under the skin, itching usually manifests.
A gastroenterologist, a doctor who diagnoses and treats patients with gastrointestinal diseases, often uses various diagnostic tools in evaluating cholangiocarcinoma cases. He may request an abdominal ultrasound or a computed tomography (CT) scan to visualize the presence of a tumor in the biliary system. An endoscopic retrograde cholangiography (ERCP) is an invasive method that involves the insertion of a scope through the mouth, down to the biliary system to locate the tumor and take tissue samples for laboratory analysis when needed.
Cholangiocarcinoma treatment may require surgery in order to remove the tumor and stop the blockage in bile flow. Chemotherapy and radiation therapy are also administered to many patients after surgery to prevent the cancer from returning. Most cholangiocarcinoma cases, however, are usually diagnosed late, thus giving patients a poorer outlook in terms of cure.