Bile Duct & Gallbladder Cancer

Bile duct structure and function

The biliary system produces a fluid called bile, which helps digest food. Bile is made in the liver and stored in the gallbladder. The bile ducts are tree-like structures within and around the liver and gallbladder. They carry bile from the liver to the upper part of the small intestine (duodenum).

Biliary cancer types

Intrahepatic bile duct cancer: Intrahepatic bile duct cancer, or intrahepatic cholangiocarcinoma, occurs in the bile ducts within the liver. It accounts for about 10% of bile duct cancer cases. It is often misdiagnosed as liver cancer. Although rare, the number of intrahepatic bile duct cancer cases is increasing.

Extrahepatic bile duct cancers: Extrahepatic bile duct cancers occur in bile ducts outside the liver. There are two types of extrahepatic bile duct cancer:

• Perihilar bile duct cancer: This is the most common type of extrahepatic bile duct cancer. It accounts for 40 to 60% of all bile duct cancer cases. The disease occurs where the bile ducts exit the liver. It is sometimes called perihilar cholangiocarcinoma or a Klatskin tumor.
• Distal bile duct cancer: This disease starts in the part of the bile ducts that passes through the pancreas and connects with the small intestine. It makes up 20 to 40% of bile duct cancer cases.

Gallbladder cancer: A cancer that arises in the wall of the gallbladder. Gallbladder cancer is often found when looking for or doing surgery to remove gallstones.

Bile duct & gallbladder cancer risk factors

Anything that increases your chance of getting biliary cancer is a risk factor. Bile duct and gallbladder cancer risk factors include:

Age: Most cases of biliary cancer in the United States are diagnosed in people between the ages of 50 and 70.

Ethnicity: In the U.S., Native Americans are more likely to get biliary cancers.

Medical conditions: Having any of the following may increase your risk for biliary cancer:

• Primary sclerosing cholangitis (PSC): A progressive autoimmune disease which scars the bile ducts over time.
• Chronic liver diseases, including:
  • Cirrhosis
  • Bile duct stones
  • Cholangitis
  • Non-viral chronic liver disease
  • Polycystic liver disease
• Hepatitis B or hepatitis C infection
• Inflammatory bowel diseases, including:
  • Crohn’s disease
  • Ulcerative colitis
• A history of bile duct cysts (choledochal) which are prone to chronic inflammation.
• Liver fluke infection: Liver flukes are parasites that are more common in South and Southeast Asia. Infection may arise due to the consumption of raw or undercooked fish.
• Exposure to thorotrast, a medical contrast agent that is no longer in use.

Smoking: Smoking increases the risk of many cancers, including bile duct cancer.

Excessive consumption of alcohol: Excessive consumption of alcohol likely increases the risk of biliary cancer. This is especially true for people who have alcohol-associated liver damage.

Family history: Several genetic disorders, including Lynch syndrome, may increase the risk of biliary tract cancers.

Learn more about bile duct cancer:

• Bile duct cancer symptoms
• Bile duct cancer diagnosis
• Bile duct cancer treatment