General Surgery and Gastroenterology Surgery Specialist Assoc. Dr. Ufuk Arslan gave information about the subject. Bile duct cancers (Cholegiocarcinoma) is a rare type of cancer arising from the bile duct wall cells. Although it develops from all biliary tracts inside and outside the liver, it most commonly originates in the hilar region, which is the junction of the right and left main bile ducts.
The most common causes of bile duct cancer are; primary sclerosing cholangitis, common duct cyst, hepatitis BC, ulcerative colitis, hepatolithiasis (liver stone), advanced age, obesity and bilenteric anastomoses are counted.
Biliary tract cancer symptoms
Usually the first symptom is painless jaundice. The reason for this is bilirubin accumulating under the skin and itching occurs. Symptoms may be accompanied by fever.
Diagnosis of bile duct cancer
It is very important to diagnose gallbladder cancer at an early stage. In the examination of biliary tract cancer, first of all, liver biliary tract ultrasound is performed. If enlargement of the biliary tract is observed, cross-sectional imaging with computed tomography or magnetic resonance aids in the diagnosis. Sudden termination of the bile ducts can be detected without a mass in the biliary tract. Biopsy or swab can be taken with ERCP (endoscopic retrogrand colongiopancreatography). Evaluation with EUS is also useful, especially in distal cancers. The fact that CA19-9, one of the tumor markers of the patient with clinical jaundice, itching and weight loss, is 100 U/ml also supports the diagnosis.
Treatment of bile duct cancer
Assoc. Dr. Ufuk Arslan said, “When the bile duct cancer is diagnosed, more than half of the patients have no chance of surgery. Since it is an insidious disease, it gives late symptoms. The level of cancer of the patients who can be operated determines the type of surgery. While hepatectomy is required for proximal cancers, whipple surgery is usually performed for distal cancers. The treatment of bile duct cancer is based on surgical removal of the tumor. It may also be necessary to remove part of the liver during treatment, which consists of a major surgery. Since the diagnosis of bile duct cancer is usually made at an advanced stage, patients often do not have the chance to undergo surgery. However, cancer that is detected early ensures successful treatment of biliary tract cancer. Some endoscopic procedures, pain treatment, percutaneous drainage (radiological intervention) can be performed to relieve jaundice and pain in patients with advanced disease that cannot be operated.