What is bile duct cancer?
Bile duct cancer forms in the ducts that carry bile from the liver to the small intestine. It can develop in several parts of that system:
- Intrahepatic cholangiocarcinoma: occurs inside the liver.
- Perihilar cholangiocarcinoma: occurs where the bile ducts enter the liver.
- Extrahepatic cholangiocarcinoma: develops outside the liver, including near the gallbladder or small intestine.
What causes it?
The exact cause remains unclear, but several factors raise the risk:
- Chronic liver disease such as cirrhosis and hepatitis.
- Primary sclerosing cholangitis (PSC): an inflammatory disease of the bile ducts.
- Liver fluke infection: more common in Southeast Asia.
- Gallstones and other bile duct abnormalities.
- Age and sex: most commonly diagnosed after 65, with higher risk in men.
Some people have several risk factors; others develop bile duct cancer with none of them.
What are the symptoms?
- Jaundice: yellowing of the skin or eyes.
- Abdominal pain, particularly in the upper right side.
- Itchy skin.
- Unexplained weight loss.
- Dark urine and pale stools.
- Fever and chills.
How is it diagnosed?
- Imaging: CT, MRI or MRCP to show the ducts and any tumour in detail.
- ERCP: to visualise the bile ducts and take tissue samples.
- Blood tests: liver function and tumour markers.
- Biopsy: tissue taken at ERCP or surgery to confirm the diagnosis.
Bile duct cancer is often diagnosed in later stages, which can limit treatment options. Early detection is critical.
What are the treatment options?
Treatment depends on the tumour's location, size and stage.
- Surgery: the most effective treatment where the cancer is confined — resection of part of the bile duct, liver or gallbladder. A liver transplant may be considered in a very select group.
- Endoscopic procedures: stenting to relieve blockage and ease jaundice where surgery is not possible.
- Chemotherapy and radiation: used when surgery is not an option; chemotherapy may shrink tumours, radiation can control growth and pain.
- Targeted therapy and immunotherapy: newer options for advanced disease or specific genetic mutations.
What is the prognosis?
Prognosis depends mainly on how early the cancer is found. Five-year survival is higher when diagnosis comes early enough for surgery to succeed. Because the disease is often caught late and is rare, ongoing research and clinical trials remain important. For more advanced cases, treatment focuses on managing symptoms and quality of life.
Can it be prevented?
- Treat liver disease early to prevent cirrhosis and its complications.
- Avoid liver fluke infection through safe food practices in high-risk areas.
- Regular screening if you have primary sclerosing cholangitis or a history of bile duct disease.
More on the biliary disease
Related conditions handled by the same team.
This page is general information about a condition we treat. It is not a diagnosis and does not replace an in-person consultation. Bring your reports — they change the answer more than the symptoms do.