What are the pathologies of bile duct cancer

For a disease like bile duct cancer, it is necessary to detect and treat it early, and not to delay the best treatment time, so as to improve the patient's survival rate. For bile duct cancer, many patients will initially show symptoms of indigestion, and some will be accompanied by abdominal pain. Understanding its pathology will help us to correctly understand the disease. So, what are the pathologies of bile duct cancer?

(1) Cancer located in the ampulla of the terminal common bile duct: The prominent symptom is the obstruction of the common bile duct and pancreatic duct, and due to the collapse of the cancer, there may be intestinal bleeding and secondary anemia. Patients often have progressive jaundice and persistent back pain, but if there are stones in the bile duct, the pain may also be colic-like. Because the pancreatic duct is sometimes blocked, it may affect the endocrine secretion of the pancreas and cause hyperglycemia or hypoglycemia, and it is more likely to cause fatty diarrhea due to the lack of exocrine secretion. The obstruction of the bile duct will also affect the digestion of fatty foods. Because the bile and pancreatic ducts are blocked at the same time, magnetic resonance pancreatocholangiopancreatography (MRCP) examination may have a typical "double duct sign", and often there is an enlarged gallbladder and liver. Jaundice may occur when the ampulla cancer lesion is very small, and ulcer bleeding is very likely to occur. The stool may be tarry and the anemia is severe. Therefore, any patient with progressive jaundice, frequent intestinal bleeding, and stubborn fatty diarrhea is very likely to have ampulla cancer.

(2) Common bile duct cancer located between the ampulla and the cystic duct: Symptoms are similar to those of pancreatic head cancer, but because the pancreatic duct is not involved, there should be no clinical manifestations of pancreatic endocrine and exocrine disorders. If the patient has not had chronic cholecystitis in the past, the gallbladder will be significantly enlarged, in accordance with Courvoisier's law.

(3) Cancer located in the common hepatic duct: Jaundice is very obvious, and the liver is also very enlarged; the gallbladder is not enlarged and sometimes only contains mucus and white bile.

Patients over 40 years old with jaundice, or digestive symptoms such as unexplained upper abdominal discomfort, bloating, and poor appetite, or liver enlargement with or without gallbladder enlargement should be suspected of cholangiocarcinoma and further examinations such as B-ultrasound, CT, MRI, ERCP, endoscopic ultrasound, choledochoscopy, PTC, hypotonic duodenography, or selective angiography can be performed to confirm the diagnosis.