Cholangiocarcinoma is a rare and aggressive cancer that originates from the cells of the bile ducts. The bile ducts are a series of thin tubes that transport bile from the liver to the small intestine.


Cholangiocarcinoma can occur at any point along the bile ducts, both inside and outside the liver.


The cancer is categorised based on its location within the bile ducts, and it can be further classified into intrahepatic (within the liver) and extrahepatic (outside the liver) cholangiocarcinoma.


Causes and Risk Factors

The exact cause of cholangiocarcinoma is not fully understood, but several risk factors are associated with its development, including:

  • Chronic inflammation of the bile ducts, often due to conditions such as primary sclerosing cholangitis and chronic biliary infections
  • Liver fluke infections, commonly found in certain regions of Asia
  • Congenital abnormalities of the bile ducts
  • Exposure to certain chemicals or toxins


Symptoms of cholangiocarcinoma may include:

  • Jaundice (yellowing of the skin and eyes)
  • Itchy skin
  • Abdominal pain, especially in the upper right quadrant
  • Unintended weight loss
  • Loss of appetite
  • Fever
  • Chills



The diagnosis of cholangiocarcinoma involves various imaging tests, such as ultrasounds, CT scans, MRIs, and endoscopic retrograde cholangiopancreatography (ERCP), which help visualise the bile ducts and identify any abnormalities. 


A biopsy may also be performed to confirm the presence of cancer cells depending on the exact location. If the cancer is within the ducts causing a narrowing and no mass lesion as such, then a biopsy is often not performed as the yield is low and the biopsy procedure is also accompanied by a risk of complications.



Treatment options for cholangiocarcinoma depend on the location and stage of the cancer, as well as the overall health of the patient. Treatment modalities may be used in combination and include:

  • Surgical resection of the tumor
  • Liver transplantation for select patients with early-stage intrahepatic cholangiocarcinoma
  • Chemotherapy and radiation therapy
  • Palliative care to manage symptoms and improve quality of life in advanced cases


Regular follow-up visits with a healthcare provider are essential for individuals diagnosed with cholangiocarcinoma to monitor the response to treatment, detect any potential recurrence, and manage any side effects or complications associated with the disease or its treatment. 


Early detection and timely intervention are crucial in improving the prognosis and outcomes for individuals with cholangiocarcinoma.

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