Extrahepatic bile duct cancer is a rare disease in which malignant
(cancer) cells form in the ducts that are outside the liver.
The extrahepatic bile duct is made up of two parts:
The extrahepatic bile duct is part of a network of ducts (tubes) that connect the liver, gallbladder, and small intestine. This network begins in the liver where many small ducts collect bile (a fluid made by the liver to break down fats during digestion). The small ducts come together to form the right and left hepatic ducts, which lead out of the liver. The two ducts join outside the liver and form the common hepatic duct. Bile from the liver passes through the hepatic ducts, common hepatic duct and cystic duct and is stored in the gallbladder.
When food is being digested, bile stored in the gallbladder is released and passes through the cystic duct to the common bile duct and into the small intestine.
Anatomy of the extrahepatic bile duct. The extrahepatic bile duct is made up of the common hepatic duct and the common bile duct. Bile is made in the liver and flows through the extrahepatic bile duct to the gallbladder where it is stored.
Having colitis or certain liver diseases can increase the risk of extrahepatic bile duct cancer.
Anything that increases your risk of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesn’t mean that you will not get cancer. Talk with your doctor if you think you may be at risk. Risk factors include having any of the following
Signs and symptoms of extrahepatic bile duct cancer include
jaundice and pain.
These and other signs and symptoms may be caused by extrahepatic bile duct
cancer or by other conditions. Check with your doctor if you have any of the following:
Tests that examine the bile duct and liver are used to detect
(find) and diagnose extrahepatic bile duct cancer.
The following tests and procedures may be used:
- Physical exam and history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.
- Ultrasound exam: A procedure in which high-energy sound waves (ultrasound) are bounced off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram. The picture can be printed to be looked at later.
- PET scan (positron emission tomography scan): A procedure to find malignant tumor cells in the body. A small amount of radioactive glucose (sugar) is injected into a vein. The PET scanner rotates around the body and makes a picture of where glucose is being used in the body. Malignant tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells do.
- Liver function tests: A procedure in which a blood sample is checked to measure the amounts of certain substances released into the blood by the liver. A higher than normal amount of a substance can be a sign of liver disease that may be caused by extrahepatic bile duct cancer.
- Tumor marker test: A procedure in which a sample of blood, urine, or tissue is checked to measure the amounts of certain substances made by organs, tissues, or tumor cells in the body. Certain substances are linked to specific types of cancer when found in increased levels in the body. These are called tumor markers. Carcinoembryonic antigen (CEA) and CA 19-9 are associated with extrahepatic bile duct cancer when found in increased levels in the body.
Certain factors affect prognosis (chance of recovery) and treatment options.
The prognosis (chance of recovery) and treatment options depend on the following:
Treatment options may also depend on the symptoms caused by the tumor. Extrahepatic bile duct cancer is usually found after it has spread and can rarely be removed completely by surgery. Palliative therapy may relieve symptoms and improve the patient's quality of life.
- Whether the tumor can be completely removed by surgery.
- Whether the tumor is in the upper or lower part of the duct.
- Whether the cancer has just been diagnosed or has recurred (come back).