Cancer can develop in the bile ducts (also known as "cholangiocarcinoma"), which carry bile from the liver to the small intestine to help digest fat. The cancer often blocks the ducts. A clogged or blocked bile duct can cause pain and other uncomfortable symptoms.
Bile duct cancer is rare and very serious. That's why it should be treated by a team of experts. The specialists at the Center for Advanced Digestive Care (CADC) of NewYork-Presbyterian/Weill Cornell Medical Center have extensive experience treating bile duct cancer, including the use of advanced endoscopic approaches to relieve obstructed ducts and improve patients' quality of life. Patients may also have access to clinical trials of new treatments to relieve symptoms and try to improve the survival rate for bile duct cancer.
Symptoms of Bile Duct Cancer
- Jaundice (yellowing of the skin)
- Loss of appetite
- Weight loss
- Upper abdominal pain radiating into the back
Diagnosis of Bile Duct Cancer
- Imaging tests such as CT scanning and magnetic resonance imaging (MRI)
- Endoscopic retrograde cholangiopancreatography (ERCP): An advanced procedure which combines x-rays and the use of an endoscope and may be used to obtain a tissue sample.
- Endoscopic ultrasound (EUS) with fine-needle aspiration to biopsy tissue: EUS involves the use of a special endoscope with high-energy sound waves ("echoendoscope") to visualize the digestive tract and nearby organs.
- Choledochoscopy: Another highly specialized endoscopic technique to visualize the common bile duct.
- Probe-based confocal endomicroscopy: A small microscope is used to analyze cells to determine if they are normal or precancerous. Cancerous tissue may be immediately removed through the endoscope for further examination. The CADC is one of few centers offering this highly specialized approach.
- Narrow band imaging of the bile ducts: With this endoscopic technique, doctors use a special system to capture high-resolution images of the bile ducts without the use of dyes. NBI relies on the fact that light of different wavelengths penetrates tissue at different depths. The longer the wavelength, the deeper the tissue penetration. Blue light penetrates superficially, while red light penetrates more deeply. By using light of different wavelengths, doctors can see fine features of the bile ducts.
Treatment of Bile Duct Cancer
The Role of Surgery
Advanced Interventional Endoscopy
- ERCP with stent placement to open a narrowed bile duct and improve quality of life in patients with advanced disease. This procedure must be performed by an advanced interventional endoscopist proficient in using this approach.
- ERCP guided by EUS to relieve obstructions in the bile ducts caused by cholangiocarcinoma, and to relieve jaundice in patients when the tumor cannot be removed.
- Laser therapy combined with light-activated chemotherapy medications ("photodynamic therapy").
- Radiofrequency ablation, which uses high-energy radio waves to treat inoperable bile duct cancers and reduce pain and other symptoms.