Bile duct cancer (cholangiocarcinoma)

Cholangiocarcinoma is an uncommon form of primary liver cancer, making up 10−15% of all primary liver cancers worldwide. It is also known as bile duct cancer and starts in the cells lining the ducts that carry bile between the liver, gall bladder and bowel. The symptoms are similar to those of HCC.

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Risk factors

The main risk factor for cholangiocarcinoma is long-term inflammation of the bile ducts. This may be caused by the same liver problems that can lead to HCC, such as hepatitis and fatty liver disease. It can also be caused by conditions such as primary sclerosing cholangitis (a liver condition) or ulcerative colitis (a bowel condition).


The main tests are ultrasound and MRI. In some cases, you may have a special MRI called a magnetic resonance cholangiopancreatography (MRCP), which shows bile ducts in more detail. Another option is an endoscopic retrograde cholangiopancreatography (ERCP). This uses a thin tube with a light and camera (endoscope) to examine the bile ducts, and can also insert a stent. Blood tests may check for a tumour marker called CA 19-9, which is raised in some people with cholangiocarcinoma.


Cholangiocarcinoma is staged using the TNM system. This gives a number to the size of the tumour (T), how many lymph nodes are affected (N), and how far the cancer has spread, or metastasised, to distant parts of the body (M).


Some people may have surgery to remove part of the liver or to insert a stent. Chemotherapy is a common treatment. This uses drugs to kill or damage cancer cells so they cannot grow or spread, and is usually given by drip into a vein. External beam radiation therapy (EBRT) may be used for advanced cholangiocarcinoma. This uses radiation to kill or damage cancer cells. SIRT, an internal radiation therapy, may be an option.

This information was last reviewed in June 2018
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