About this disease
What it concerns
Risk factors for the development of tumors originating from the gallbladder or bile duct are often chronic inflammation of the bile ducts (chronic cholangitis and primary sclerosing cholangitis) or tropical and subtropical travel diseases, such as parasites in the bile ducts. The so-called ulcerative colitis, a chronic inflammatory disease of the colon, is also associated with the development of such carcinomas.
Types
Different types of gallbladder and bile duct cancer are distinguished according to the location of the tumor of origin. This can be located in the so-called intrahepatic bile ducts, which comprise all bile ducts up to the hepatic orifice, in the center of the liver (Klatskin tumor), in the so-called distal extrahepatic bile duct, which is located outside the liver, or in the confluence of the bile duct with the intestine (papillary carcinoma).
Symptoms and consequences
Tumors in the gallbladder and bile duct initially usually lead to nonspecific symptoms. Obstruction of the bile ducts, for example, leads to darkening of the urine and discoloration of the stool. In addition, disturbing itching and weight loss may occur. Tumor-induced swelling of the gallbladder is known as Courvoisier's sign: The bulging gallbladder compresses the bile ducts, causing bile to back up.
How we can help you
Examination and diagnosis
An ultrasound examination, computer tomography (CT) or magnetic resonance imaging (MRI) can be used to determine where the bile duct carcinoma is located. Magnetic resonance cholangiopancreaticography (MRCP) can be performed as a complementary procedure to diagnose the exact location. Endoscopic retrograde cholangiopancreatography (ERCP), which allows visualization of the bile ducts and gallbladder using contrast medium is in this case used therapeutically to restore bile flow, at least temporarily.
Treatment
The treatment plan is discussed during the interdisciplinary tumor case discussion, the so-called tumor board. In early stages, surgical removal may be attempted, followed by complementary chemotherapy or radiation. In a case where tumors cannot be operated on, then radiation alone, chemotherapy or a combination of both therapies may be considered in order to best control the tumor disease.