Comprehensive Care for Advanced Bile Duct Health

What Are Biliary Cancers?

Biliary cancers, also known as bile duct cancers or cholangiocarcinomas, are rare but serious cancers that develop in the bile ducts, which carry bile from the liver and gallbladder to the small intestine. These cancers can occur in different parts of the bile ducts:

• Intrahepatic: Within the liver.
• Perihilar: Where the bile ducts exit the liver (also known as Klatskin tumors).
• Distal: Near the pancreas and small intestine.

At Central Gastro, we provide expert diagnosis, treatment, and management of biliary cancers with a multidisciplinary approach that prioritizes patient outcomes and quality of life.

Types of Biliary Cancers

1. Cholangiocarcinoma (Bile Duct Cancer):

• The most common form of biliary cancer, occurring in the bile ducts inside or outside the liver.

2. Gallbladder Cancer:

• A rare cancer that starts in the gallbladder but can spread to nearby bile ducts.

3. Ampullary Cancer:

• Cancer arising at the junction where the bile duct and pancreatic duct meet the small intestine.

Symptoms of Biliary Cancers

Symptoms often develop in advanced stages and may include:

• Jaundice: Yellowing of the skin and eyes due to bile buildup.
• Abdominal Pain: Particularly in the upper right side.
• Unexplained Weight Loss: Often accompanied by loss of appetite.
• Dark Urine and Pale Stools: Caused by bile duct obstruction.
• Itchy Skin (Pruritus): Due to bile salts in the bloodstream.
• Fever or Chills: Possible signs of infection.

If you experience these symptoms, it’s crucial to seek medical evaluation promptly.

Risk Factors for Biliary Cancers

• Chronic bile duct inflammation or infections (e.g., primary sclerosing cholangitis, PSC).
• Bile duct stones or choledochal cysts.
• Liver fluke infections (common in certain regions).
• Chronic liver disease or cirrhosis.
• Family history of biliary or gastrointestinal cancers.
• Exposure to certain toxins or chemicals.

Diagnosis of Biliary Cancers

At Central Gastro, we use advanced diagnostic tools to accurately identify and stage biliary cancers:

1. Blood Tests:

• Liver Function Tests (LFTs): To assess bile flow and liver health.
• Tumor Markers: 
  • CA 19-9 and CEA: Markers commonly elevated in biliary cancers.

2. Imaging Studies:

• Ultrasound: Initial imaging to detect bile duct abnormalities. 
• CT Scan or MRI: Detailed imaging to assess the tumor’s size, location, and spread.
• MRCP (Magnetic Resonance Cholangiopancreatography): Non-invasive imaging of bile ducts and surrounding structures.

3. Endoscopic and Interventional Diagnostics:

• Endoscopic Ultrasound (EUS): Combines endoscopy and ultrasound to evaluate tumors and obtain biopsies. 
• ERCP (Endoscopic Retrograde Cholangiopancreatography): Visualizes bile ducts, collects biopsies, and relieves blockages. 

4. Biopsy:

• Tissue samples are analyzed to confirm the diagnosis and determine the cancer type.

Treatment Options for Biliary Cancers

Our team at Central Gastro provides a comprehensive, patient-focused approach to biliary cancer treatment:

1. Surgical Options

• Resection: Removal of the affected bile ducts or gallbladder.
• Whipple Procedure (Pancreaticoduodenectomy): For cancers near the pancreas.
• Liver Resection or Transplantation: In select cases of intrahepatic cholangiocarcinoma or advanced PSC-related cancers.

2. Minimally Invasive and Palliative Procedures

• Biliary Stenting: To relieve obstructions and improve bile flow.
• Biliary Drainage: Percutaneous or endoscopic techniques to alleviate symptoms.

3. Ablative Therapies

• Radiofrequency Ablation (RFA): To destroy cancer cells and relieve symptoms.
• Photodynamic Therapy (PDT): Uses light-sensitive drugs to target cancer cells.

4. Chemotherapy and Radiation Therapy

• Adjuvant Chemotherapy: After surgery to reduce recurrence risk.
• Palliative Chemotherapy or Radiation: To slow cancer progression and alleviate symptoms.

5. Targeted Therapies and Immunotherapy

• Targeted Therapy: Drugs like FGFR inhibitors for specific genetic mutations in cholangiocarcinoma.
• Immunotherapy: Harnessing the immune system to attack cancer cells in advanced cases.