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Bile Duct Cancer (Cholangiocarcinoma)

Bile duct cancer, also known as cholangiocarcinoma, is a rare and aggressive form of cancer that develops in the bile ducts, which carry bile from the liver to the small intestine. This cancer is often diagnosed at an advanced stage, making early detection and treatment essential for better outcomes.

The exact cause of bile duct cancer is not fully understood, but several risk factors have been identified:

  • Primary sclerosing cholangitis (PSC) – a chronic liver disease that causes inflammation and scarring of the bile ducts.
  • Chronic bile duct inflammation – conditions such as bile duct stones or infections increase the risk.
  • Liver fluke infections – parasitic infections, common in certain parts of the world, can contribute to bile duct cancer.
  • Hepatitis B and C infections – chronic liver diseases increase the risk of cholangiocarcinoma.
  • Congenital liver or bile duct abnormalities – such as Caroli disease or choledochal cysts.
  • Exposure to toxins – certain chemicals and toxins have been linked to an increased risk of bile duct cancer.

Bile duct cancer may not cause symptoms in its early stages. As the disease progresses, symptoms may include:

  • Jaundice (yellowing of the skin and eyes)
  • Dark urine and pale stools
  • Abdominal pain, particularly in the upper right side
  • Unexplained weight loss
  • Fatigue and weakness
  • Itchy skin (pruritus).

Diagnosing bile duct cancer requires a combination of tests and imaging studies:

  • Blood tests – liver function tests and tumor markers such as CA 19-9.
  • Imaging studies – ultrasound, CT scan, MRI, and MRCP (magnetic resonance cholangiopancreatography) to visualize the bile ducts.
  • Endoscopic procedures – ERCP (endoscopic retrograde cholangiopancreatography) or biopsy to confirm the diagnosis.

The choice of treatment depends on the stage and location of the tumor. Treatment options include:

  • Surgical resection – Removing the tumor if the cancer is detected early and is localized.
  • Liver transplantation – An option for select patients with early-stage bile duct cancer.
  • Radiation therapy – Used in cases where surgery is not possible.
  • Chemotherapy – To slow tumor progression, especially in advanced cases.
  • Palliative care – Managing symptoms and improving quality of life in late-stage disease.

At Karolinska University Hospital, our experienced team can provide comprehensive diagnosis, treatment, and rehabilitation.

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