Extrahepatic Biliary Cancer

Overview
  • Here we discuss cancers arising in the extra-hepatic biliary tree as distinguished from those arising in the intrahepatic biliary tree which are covered in cholangiocarcinoma. Cancers arise most often in the gallbladder and are generally adenocarcinomas. Extrahepatic biliary cancers are highly malignant, have invaded by the time of diagnosis, and consequently have an extremely poor prognosis
Gallbladder Cancers
  • Pathogenesis of gallbladder cancers appears to be linked to chronic cholecystitis due to longterm presence of gallstones within the tallbladder lumen. Symptomology is generally very mild leading to diagnosis only at very late stages. Symptoms are often similar to that of chronic cholecystitis and includes mild right upper quadrant abdominal pain along with weight loss.
Cancers of the Extrahepatic Bile Ducts and Ampulla of Vater
  • The pathogenesis of these cancers is not known and does not appear to be correlated with gallstones
  • Clinical features are those of general cholestasis which include jaundice, pruritis, conjugated hyperbilirubinemia, elevated serum alkaline phosphatase, and intestinal lipid malabsorption leading to steatorrhea.