What is liver disease? What is pancreatic cancer? What are liver tumors

How do I get treatment?

For further information and appointments please see the below contact numbers:

For Mr Rob Hutchins:

020 7234 2940

For the following Consultants:

020 7234 2730

Professor Nigel Heaton
Mr Parthi Srinivasan
Mr Andreas A. Prachalias
Dr Phil M. Harrison
Dr Michael Heneghan

Biliary Cancer Treatment London, Gallbladder and Bile Duct Cancer treatment in London

About Biliary Cancer, Cancer of the Gallbladder and Bile Ducts (Cholangiocarcinoma)

What is the Bile duct system?

The bile duct system

Bile is a fluid produced by the liver which aids digestion by promoting the breakdown of fats within the duodenum and the absorption of vitamins D and E and which reaches the duodenum via the bile duct system.

Originating within the liver, tiny thin drainage ducts exist which then drain into large ducts transporting bile towards the duodenum. These small drainage ducts carry bile (which is a mixture of cholesterol, acids, salts and waste products) from the liver to the gall bladder and then from the gall bladder to the small intestine. The gall bladder stores bile until you eat when it then releases bile into the small intestine as an aid to digesting food.

Because of its structure and appearance, the bile duct system is often referred to as the biliary tree. If there is a problem such as a blockage within the bile duct system, urine can become darker, faeces (stools) paler and the skin becomes tinged with yellow. This is known as jaundice.

Bile duct cancer

Bile duct cancer is not a common cancer but it can occur anywhere within the bile duct system, including the gall bladder ( a pear-shaped sac that hangs off the bile tubes outside the liver which concentrates and stores bile) the bile ducts within the liver (intrahepatic cholangiocarcinoma – the right and left hepatic ducts) or part of the bile duct system outside the liver (extrahepatic cholangiocarcinoma – where the right and left hepatic ducts join right down to the termination of the distal common bile duct.)

Biliary cancers account for 10-15% of all primary liver cancers and 3% of all gut cancers worldwide. It cccurrs in about two in every 100,000 people, although it can occur in both male and female of all ages, it is more likely to occur in those people over 65 years. High-risk areas include Thailand, Japan, Korea, Eastern Europe (European Russia, Czech Republic, Poland), and American Indians.

Risk Factors of Bile Duct Cancer:

Age: the chances of developing gallbladder cancer increase as you get older. Most people diagnosed with gallbladder cancer are in their 70s. Bile duct cancer is most common in those over 65. Bile duct cancers are slightly more common in men but gallbladder cancer is overwhelmingly more common in women.

Bile duct abnormalities: the bile duct and pancreatic duct enter the gut as a single common channel guarded by a muscular valve. If they connect above this guardian valve, reflux may occur between the two and predispose patients to bile duct cancers.

Bile duct stones: gallstones sometimes escape the gallbladder down the bile duct. It is more common for bile duct stones to be found in South East Asian patients leading to bile duct cancer. Tropical pyogenic cholangitis is more common in these patients too and is a risk factor.

Congenital abnormalities of the bile ducts: these include choledochal cysts, which is a dilation or stretching of the common bile duct, and Caroli’s Disease — a dilation of the bile ducts within your liver (intrahepatic ducts).

Diet: high carbohydrate, low fibre diets may increase the incidence of gallbladder cancer.

Gallstones: these are the most common risk factor for gallbladder cancer. Poor gallbladder emptying with stone disease may increase the exposure to toxins in the bile. Also inflammatory change within the gallbladder may cause more rapid turnover of cells with more chance of “mistakes” occurring in the genetic make up of the new cells.

Gallbladder polyps: these are small growths inside the gallbladder which are more likely to become cancers if they are larger (>1cm). However cancers have rarely been found even in tiny polyps.

Hazardous chemicals and toxic substances: people exposed to certain industrial chemicals have an increased risk of developing gallbladder cancer. The list of potential harmful chemicals is increasing. Many have a similar structure to naturally-occuring bile acids.

Obesity: if you are very overweight you are at increased risk of gallbladder cancer.

Parasitic infections: these are primarily a concern in Asian countries. A rare form of bile duct cancer (although it is more common in Asia) is caused by Clonorchis Sinensis, a form of roundworm found in raw freshwater fish.

Primary sclerosing cholangitis (PSC) this autoimmune disorder causes your immune system to attack your bile ducts. It is associated with inflammatory bowel diseases such as ulcerative colitis