Bile duct cancer diagnosis

The attending gastroenterologist carries out the primary diagnosis. If a bill duct tumor is suspected, the patient is referred for laboratory blood and urine tests. A golden standard for bile duct diagnosis, so-called endoscopic retrograde cholangiography (ERCP) is effective in detecting the ducts blocked by the tumor. The doctor inserts an endoscope into the duodenum, puts a thin catheter into the bile duct, and injects a contrast solution. As a result, the contours of the ducts become visible in the images. Next, an ultrasound of the abdomen, CT, and MRI are used to clarify the diagnosis. MRI distinguishes benign from malignant tumors, while CT is better suited for imaging lymph nodes. The oncologist also checks for the expansion of the intrahepatic bile ducts, determines the tumor localization and size, and sees the presence of metastases. Finally, a biopsy of the bile duct tumor will help confirm the diagnosis. The most reliable way is to get a fragment and examine it under a microscope. A biopsy can be performed in different ways: during cholangiography or using a special needle inserted into the tumor under ultrasound or computed tomography control. In many cases, a biopsy for bile duct cancer is not recommended as it's already enough data to confirm the tumor. Based on test results, the oncologist can decide on treatment tactics and the possibility of surgery.