hepatic and biliary disorders
Tumors of the Gallbladder and Bile Ducts
Diagnosis of Gallbladder and Bile Duct Tumors
Ultrasonography (sometimes endoscopic), followed by Magnetic resonance imaging (MRI) (MRCP) or CT cholangiography Sometimes endoscopic retrograde cholangiopancreatography (ERCP) Cholangiocarcinomas and gallbladder carcinomas are suspected when extrahepatic biliary obstruction is unexplained. Laboratory test results reflect the degree of cholestasis. In patients with Primary Sclerosing Cholangitis (PSC) , serum carcinoembryonic antigen (CEA) and carbohydrate antigen (CA) levels 19-9 are measured periodically to check for cholangiocarcinoma. Diagnosis is based on ultrasonography (or endoscopic ultrasonography), typically followed by MRCP (see Imaging Tests of the Liver and Gallbladder ). CT is sometimes done and may provide more information than ultrasonography, particularly for gallbladder carcinomas. When these methods are inconclusive or if cholangiocarcinoma is suspected, Open laparotomy is necessary to determine disease extent, which guides treatment. 