Bile Duct Tumors


About Bile Duct Tumors

Bile duct is the tubular structure that is involved in transmitting the bile from liver to intestines. This duct passes through pancreas before entering the small intestine (duodenum). The problems associated with bile duct and pancreas tend to produce jaundice as they block the flow of bile.

Common Bile Duct (CBD) transmits the bile from liver to intestine. In doing so the duct passes through the pancreas, where the pancreatic duct joins it. The duct from gall bladder (cystic duct) also joins the CBD.

Pancreas is a gland located behind the stomach. It secretes both digestive juices and hormones like insulin. Both these functions are very important for the normal functioning of the body. Common bile duct passes through head of the pancreas and joins the duct of the pancreas before joining intestine. Pancreas also has body and tail (see below), diseases of which do not cause jaundice.

SYMPTOMS AND DIAGNOSIS

The most common symptom of cancers bile duct & pancreas are:

  • Unexpected weight loss & loss of apatite could be one of the earliest symptoms. This occurs because of changes in digestion.
  • Jaundice is when eyes turn yellow. This occures early in case of cancers of common bile duct and head of pancreas.
  • Itching occurs because of jaundice.
  • The juices secreted by liver and pancreas are very important in digestion. Indigestion (dyspepsia) and change in color of stool (feces) very common.
  • Vague pain in the upper part of abdomen could be the only symptom in some cases.
  • The diagnosis is reached based on investigations which include various blood tests including liver functions tests and imaging tests like CT scan and MRI scan. A needle biopsy should never be performed on a suspected gallbladder cancer as this can spread the disease. Rarely a biopsy is needed. If the investigations shows a cancer far too progressed for a curative procedure, then only a needle biopsy is planned.

BILE DUCT CANCER & TREATMENT

These are called cholangiocarcinoma. They present with jaundice. Treatment depends on which portion of the duct the cancer has affected. If upper part is affected, a portion liver has to be removed with the cancer (right or left hepatectomy). If lower portion is involved, pancreas will have to be removed along with the cancer (pancreatico-duodenectomy or Whipple’s Surgery)similar to pancreatic head cancer.

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