Diagnosis of Bile Duct Cancer

Diagnosis of Bile Duct Cancer

Diagnosing cholangiocarcinoma can be difficult due to its deep location within the body and non-specific symptoms. Many signs mimic other, more common illnesses like gallstones or hepatitis. A combination of imaging tests, blood work, and biopsies is usually required. Learn more about the diagnosis of bile duct cancer below.

Step-by-step diagnostic process:

1. Medical history and physical exam
   • Doctors look for jaundice, weight loss, right upper quadrant tenderness, and signs of liver disease.
     
2. Blood tests
   • Liver function tests (LFTs): Reveal bile obstruction or liver damage.
   • Tumour markers: CA 19-9 and CEA levels may be elevated, although not specific.
     
3. Imaging tests
   • Ultrasound: A first-line, non-invasive way to assess bile ducts and liver.
   • CT scan: Provides more detail and can detect masses or enlarged lymph nodes.
   • MRI with MRCP: A specialised scan that shows bile ducts in greater detail.
   • ERCP (endoscopic retrograde cholangiopancreatography): Allows both imaging and biopsy during an endoscopic procedure.
   • PTC (percutaneous transhepatic cholangiography): Used when ERCP isn’t possible.
     
4. Biopsy
   • A tissue sample may be taken via ERCP, laparoscopy, or guided needle biopsy to confirm the diagnosis.
     
5. Staging
   • Once confirmed, further scans assess how far the cancer has spread — to nearby blood vessels, lymph nodes, or other organs.

In South Africa, diagnostic access depends on location. Major hospitals and academic centres offer CT, MRI, and ERCP, but availability may be limited in rural or underfunded public facilities.

Diagnosis of Bile Duct Cancer

Because early symptoms are vague, delays in diagnosis are common. Prompt referral to a gastroenterologist, hepatologist, or oncologist is vital when jaundice or unexplained liver symptoms are present.

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