What is bile duct cancer?
The bile ducts are part of the 
. They are tubes that carry bile. This is a fluid that helps your body digest food.
Bile duct cancer is when abnormal cells in a bile duct divide in an uncontrolled way. The cells can spread into surrounding healthy tissues or organs, like the bowel or pancreas. They may also spread to parts of the body away from the bile duct.
Bile duct cancer is also called cholangiocarcinoma (pronounced kol-an-gee-oh-car-sin-oh-ma).
This video shows where the bile ducts are, what they do and the different areas where bile duct cancer can develop. The video is 1 minute and 30 seconds long.
The gallbladder is a small organ tucked under the liver. It is a small, hollow pouch about 8cm long and 2.5cm wide and is connected to the liver and bowel by a series of tubes known as the bile ducts.
The liver makes bile which helps to break down fats from food. The gallbladder stores the bile until there are fats in the bowel that need digesting. Bile can also pass directly to the bowel from the liver. A sphincter controls the release of bile into the bowel.
Cancer of the gallbladder and bile ducts are rare in the UK. They are called biliary cancers.
Bile duct cancers are divided into 3 types depending on where they develop. Intrahepatic bile duct cancer forms inside the liver. Perihilar bile duct cancer forms just outside the liver where the right and left hepatic ducts meet. And distal bile duct cancer forms in the bile ducts that go through the pancreas to the small bowel.
Lymph nodes surround these organs and make up part of our immune system, helping us fight infections. They are often the first place cancer cells reach when they break away from a tumour.
For information about gallbladder and bile duct cancers go to cruk.org/cancer-types
The bile ducts
Bile ducts carry bile from your liver, where it is made, to your gallbladder where it is stored.
When you eat, your gallbladder releases bile back into the bile ducts. It flows to the small bowel where it breaks down fat in the food you've eaten. This makes it easier for your body to use the food.
There two main bile ducts in the liver. These are the:
- right hepatic duct
- left hepatic duct
They join together just outside the liver to make the common hepatic duct. Bile flows down this duct and into the cystic duct. This is connected to the gallbladder.
When we eat, bile is released from the gallbladder back into the cystic duct. It then flows down the common bile duct.
Before it gets to the small bowel, the common bile duct joins the pancreatic duct. This releases pancreatic juice which also breaks down food to make it easier to use.
Where bile duct cancer develops
Doctors divide bile duct cancer into 3 groups depending on where it starts:
-
intrahepatic bile duct cancers
-
perihilar bile duct cancers
-
distal bile duct cancers
Intrahepatic bile duct cancer
Starts in the bile ducts inside the liver.
Intrahepatic bile duct cancer is also called intrahepatic cholangiocarcinoma.
Perihilar bile duct cancer
Starts in the bile ducts just outside the liver, but before the cystic duct joins the common hepatic duct.
Perihilar bile duct cancer is also called a Klatskin tumour or hilar cancer.
Distal bile duct cancer
Starts in the bile ducts below where the cystic duct joins the common hepatic duct.
Who gets bile duct cancer?
Anything that can increase your risk of cancer is called a risk factor. Having one or more risk factors doesn’t mean you'll definitely get bile duct cancer.
Bile duct cancer is more common in older people. The risk is also higher in people who have:
- a rare type of
cyst in their bile ducts called a choledochal cyst - inflammation in their bile ducts called primary sclerosis cholangitis (PSC)
- had an injection of a contrast medium called Thorotrast in the past – this was used until the 1960’s
- worked with a chemical called 1,2-dichloropropane for a long time – this is used in the printing industry
Other risk factors depend on which bile duct the cancer is in and where in the world you live.
How common is bile duct cancer?
In the UK, around 3,100 people are diagnosed with bile duct cancer each year.
The number of people getting bile duct cancer has increased in the last few years. Researchers don't know for sure what's causing the number to increase. Some studies suggest it might be related to lifestyle choices such as smoking and drinking alcohol.
These statistics are based on the average number of new cases of bile duct cancers (ICD10 C22.1, C24.0, C24.8 and C24.9) in the UK between 2017 and 2019.
