Cholangiocarcinoma

This is an uncommon primary malignant tumour (cancer) of the bile ducts, which can arise in the small bile ducts within the liver, the big branches in the centre of the liver (hilum) or in the main bile duct draining out of the liver. It is increasing in frequency in the UK for reasons that are not fully understood. It is more common in patients who have had tropical parasitic infestations of the bile ducts (clonorchis), originate from north west asia (Afghanistan / Pakistan / north west India) or have had sclerosing cholangitis (chronic inflammation of the bile ducts).

Cholangiocellular carcinoma (CCC) is the second common primary liver tumour after hepatocellular carcinoma (CCC). It can arise from either the distal or proximal extrahepatic duct including bifurcation or from the intrahepatic ducts. It is more common in patients who have had tropical parasitic infestations of the bile ducts (clonorchis) or have had sclerosing cholangitis (chronic inflammation of the bile ducts).

CCCat the hilum (Klatskin Tumours) can be treated surgically if they are diagnosed in an early stage .The procedure involves the removal of  the bile duct and the most involved part of the liver with all the regional nodes. If they are invading the major adjacent vessels (portal vein and hepatic artery), surgical treatment can be difficult. The presence of distant spread (metastasis)makes surgery impossible.
CCCs inside the liver can be treated surgically by removing the involved area of the liver.

CCCs of the lower bile duct are treated with a pancreatic head resection (Whipple’s procedure).