It is a rare type of cancer that develops in the small tubes that connect the liver and gallbladder to the small bowel. About Cancer generously supported by Dangoor Education since Questions about cancer?
Call freephone 9 to 5 Monday to Friday or email us. Skip to main content. Home About cancer Bile duct cancer What is bile duct cancer? Bile duct cancer is also called cholangiocarcinoma pronounced kol-an-gee-oh-car-sin-oh-ma. Content not working due to cookie settings. Manage your cookie settings here. Cancer of the gallbladder and bile ducts are rare in the UK.
They are called biliary cancers. Find out more about what cancer is and how it starts. Find out more about the different types of bile duct cancer.
Where this information comes from. Find out about the risks and causes of bile duct cancer. Related links. The gallbladder is about the size of an egg when full. The bile duct below the cystic duct is usually called the common bile duct. The common bile duct and the common hepatic duct together constitute the main bile duct. The lower end of the bile duct sweeps around behind the duodenum and through the head of the pancreas before joining the pancreatic duct at the main papilla of Vater.
There is a main pancreatic duct which collects juices from all the branches of the pancreatic stream, and exits at the main papilla of Vater. The pattern of these branches varies considerably, but this does not matter. This normal arrangement comes about as a result of complex reorganization during fetal development. Early in the development of the embryo, the pancreas is in two parts dorsal and ventral elements.
These parts usually join together to form one pancreas between six and eight weeks of pregnancy. Even after joining, the santorini stays open or "patent," and drains into the minor papilla in over half of patients. Thus, the patient who develops a problem at the main papilla like a stone or tumor may not develop any symptoms of pancreatic obstruction if Santorini's duct and the minor papilla are open, and can take over the drainage function. However, this fusion joining does not happen in about one in twelve people at least in western populations.
Then the pancreas remains divided so called "pancreas divisum". In patients with divisum, the largest dorsal part of the pancreas drains through Santorini's duct and the minor papilla, while only a small part the ventral pancreas drains through the usual major papilla.
The importance of this is that the minor papilla may be too small to allow easy passage of the pancreatic juices; and some patients with pancreas divisum can develop attacks of pain and pancreatitis as a result due to this relative narrowing. There are other rarer variations of pancreatic anatomy. Annular pancreas describes a congenital condition in which one of the branches of the pancreas swings all around the duodenum; this can narrow the duodenum sufficiently to cause obstruction and require operation.
This condition usually presents in infancy for obvious reasons , but can be discovered only later in life if the narrowing is not so tight, and sometimes when attacks of pancreatitis are associated with it. Other anomalies of pancreas development produce interesting pictures, but are not of clinical importance. The tissues of the pancreas acinar cells produce a clear digestive fluid made up of bicarbonate, and enzymes. Bicarbonate is alkaline, and helps digestion by neutralizing the stomach acid containing the food as it passes into the duodenum.
The enzymes are more important. These are designed to help breakdown digest complex carbohydrates sugars , proteins, and fats in the food. The main enzymes are called amylase, proteases trypsin, chymotrypsin , and lipase. The enzyme and bicarbonate secretions together are called the "exocrine" function of the pancreas. These cancers start in the smaller bile duct branches inside the liver.
Sometimes they're confused with cancers that start in the liver cells hepatocellular carcinomas , and they are often treated the same way.
These cancers start at the hilum, where the left and right hepatic ducts have joined and are just leaving the liver. These are also called Klatskin tumors. These cancers are grouped with distal bile duct cancers as extrahepatic bile duct cancers. When the liver cells secrete bile, it is collected by a system of ducts that flow from the liver through the right and left hepatic ducts.
The common hepatic duct then joins with the cystic duct from the gallbladder to form the common bile duct. This runs from the liver to the duodenum the first section of the small intestine.
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