liver and gallbladder disorders
Tumors of the Bile Ducts and Gallbladder
Diagnosis of Bile Duct and Gallbladder Tumors
Ultrasonography, followed by other imaging tests Sometimes endoscopic retrograde cholangiopancreatography (ERCP) or taking a tissue sample Doctors suspect bile duct or gallbladder cancer when a bile duct is blocked and no other cause is identified. Bile duct cancer is suspected especially in people with Primary Sclerosing Cholangitis (PSC). If people have PSC, blood tests to measure substances secreted by tumors (tumor markers) are done periodically to check for this cancer. The diagnosis is confirmed by Imaging Tests of the Liver and Gallbladder . Usually, ultrasonography is done first. Sometimes computed tomography (CT) is done, but results are often not conclusive. CT cholangiography (CT of the bile ducts done after a radiopaque contrast agent is injected into a vein) or magnetic resonance cholangiopancreatography (MRCP) is usually necessary. If results of imaging tests are unclear, Endoscopic Retrograde Cholangiopancreatography (ERCP) is done. In this procedure, a flexible viewing tube (endoscope) is inserted through the mouth and into the small intestine. A thin tube (catheter) is inserted through the endoscope, and a radiopaque contrast agent, which is visible on x-rays, is injected through the catheter into the bile ducts. Then x-rays are taken to detect any abnormalities. This procedure enables doctors to obtain images and a tissue sample for examination under a microscope (see figure If these tests suggest a tumor but are not conclusive, doctors may take a tissue sample by inserting a thin needle through the skin into the area thought to be abnormal. Ultrasonography or CT is used to guide the needle. To determine how extensive the cancer is, doctors may have to do surgery to directly examine the area (a procedure called a diagnostic laparoscopy or an open laparotomy). 