Types of bile duct cancer
Bile duct cancer is also called cholangiocarcinoma. There are 3 main types, depending on where in the bile ducts the cancer starts. They are:
- intrahepatic bile duct cancer
- perihilar bile duct cancer
- distal bile duct cancer
This video shows where the bile ducts are 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
Intrahepatic bile duct cancer
There are a number of small bile ducts in the liver. These join together to make larger ducts called the right and left hepatic duct.
Cancer that starts in the bile ducts in the liver is called intrahepatic bile duct cancer.
Sometimes your doctor might find it difficult to tell if you have intrahepatic bile duct cancer, or cancer that started in the liver cells. Cancer that starts in the liver cells is called hepatocarcinoma. Your doctor might recommend taking a piece of tissue (biopsy) from the cancer to check which one it is.
Perihilar bile duct cancer
The perihilar bile ducts are outside the liver. They leave the liver just before the left and right hepatic duct meet. And stop where the cystic duct joins the common hepatic duct.
Cancer that starts in the perihilar bile ducts is called perihilar bile duct cancer. It can also be called a Klatskin tumour or hilar cancer.
Distal bile duct cancer
The distal bile ducts start where the cystic duct joins the common hepatic duct. This forms the common bile duct which takes bile to the small bowel.
Cancer that starts in this area is called distal bile duct cancer.
Gene changes (mutations) in the cancer
Your doctor might check the bile duct cancer cells to see if they have certain 
changes (mutations). These changes can help the cancer grow and divide. Knowing if the cancer has these changes can help your doctor decide on the best treatment for you.
This is a type of personalised medicine.
Other types of bile duct cancer
The bile ducts are lined by a layer of tissue called epithelial tissue. There are different types of epithelial tissue cell. Most cancers of the bile duct start in epithelial cells that keep the tissue moist. These cancers are called adenocarcinomas.
There are a number of other types of bile duct cancer. These types are very rare and include:
squamous cell carcinoma sarcoma lymphoma
Non cancerous bile duct tumours
Non cancerous (benign) tumours can also grow in the bile ducts. They include bile duct and hamartomas. A bile duct hamartoma is where normal bile duct tissue overgrows to form a lump.
