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Bile Duct Cancers

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Bile ducts are a network of tubes connecting the liver, gallbladder, and small intestine.  Their purpose is to transport bile, a fluid made in the liver. Bile breaks down fats during digestion. 

This network, starting in the liver, is where many small ducts collect bile. They merge to form the right and left hepatic ducts, which lead out of the liver and unite again to form the common hepatic duct. The cystic duct connects the gallbladder to what's called the common hepatic duct. Bile from the liver then passes through the hepatic ducts, common hepatic duct, and cystic duct and is stored in the gallbladder.

Bile duct cancer, also called biliary cancer or cholangiocarcinoma, can grow in any part of the bile ducts. Bile duct cancers are named for where they start. Each type can cause different symptoms.

Types of Bile Duct Cancers

Cholangiocarcinoma is named for where it starts in the body. Each can cause different symptoms. Bile duct cancers include:

  • Perihilar bile duct cancers: These cancers grow just outside of the liver in the hilum: where the main right and left bile ducts join as they leave the liver. Most instances of bile duct cancer occur in this area.
  • Intrahepatic bile duct cancers: A small percentage of bile duct cancers grow in these tiny bile ducts inside the liver and are sometimes classified as a type of liver cancer
  • Distal bile duct cancers: These cancers grow in the common bile duct near the first part of the small intestine.

Why Choose Sylvester Comprehensive Cancer Center?

Sylvester is the only NCI-designated cancer center in South Florida. The team earned this distinction through its outstanding work conducting research in its laboratories, treating patients in its clinics and hospitals, and reaching out to medically underserved communities with innovative prevention strategies.

Receive treatment from a team of experts. Your care team includes some of the top medical oncologists, radiation oncologists, surgeons, pathologists and researchers in the country — all working for you.

High volume experience with gallbladder and bile duct/biliary. We achieve better treatment outcomes and fewer potential complications.

Leading laparoscopic and robotic-assisted surgery expertise. Our advanced experience allows us to fight cancer with greater precision and offer you a faster recovery.

Minimally invasive NanoKnife® radiosurgery. We offer more options for people with inoperable or difficult-to-reach gallbladder or biliary tumors. This approach causes little pain and requires only a brief hospital stay.

Advanced radiation oncology tools. Sylvester was the first medical center in Florida, and the fourth in the country to offer resonance magnetic-guided radiation therapy. Our team is a leader in that domain. Our RapidArc® radiotherapy system delivers intensity-modulated external radiation therapy (IMRT). These tools lead to more efficient and effective treatments, shorter treatment times, pinpoint accuracy in tumor targeting and less damage to surrounding healthy tissue. Finally, our radiation oncology department also offers proton beam therapy in our state-of-the-art Dwoskin Proton Therapy Center.

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Treatments

Many factors determine the best treatment for your cancer: tumor size, location, and stage; your body; your lifestyle; and your overall health. The experts at Sylvester will work together to devise your most effective treatment plan.           

  • Surgery

    • Cholecystectomy: Removal of the gallbladder in early or pre-cancerous disease stages (simple cholecystectomy) or removal of the gallbladder and nearby tissue, organs in more advanced cases (extended cholecystectomy).

    • NanoKnife radiosurgery (irreversible electroporation or IRE): Short, repetitive, high-energy pulses of electricity destroy cancer cells. IRE occurs before or during surgery.

    • Biliary bypass: A surgically created pathway for the body to drain bile into the small intestine when bile ducts are blocked.
    • Endoscopic stent placement: A minimally invasive laparoscopic (“keyhole”) surgery that places a stent (flexible mesh tube) in the bile duct to drain bile outside of the body or into the small intestine.

    • Percutaneous transhepatic biliary drainage: IUltrasound-guided stent placement to hold bile ducts open. This procedure may be used when endoscopic stent placement isn’t possible.

    • Radiofrequency Ablation: High-energy radiation beams safely treat pain and symptoms caused by inoperable tumors blocking the bile duct.

    • Robotic-assisted Whipple procedure (pancreaticoduodenectomy): Removal of nearby organs affected by cancers in the lower part of the bile duct. Our expertise offers smaller incisions, less blood loss, and potentially faster recovery time.

  • Radiation Therapy 

    External beam radiation: Radiation that’s precisely targeted to your tumor and delivered from outside your body. This technique is also used to relieve symptoms. Our advanced technology includes intensity modulated external radiation therapy (IMRT) and ViewRay MRI-guided radiation therapy.   

  • Chemotherapy (Systemic Medical Therapy):
    Chemotherapy is a combination of cancer-fighting medicines administered intravenously or taken as a pill. It’s usually combined with surgery or radiation therapy to increase impact.

    • If you require intravenous (infusion) chemotherapy, you can receive it at the Comprehensive Treatment Unit (CTU) at Sylvester's main location in Miami. This 12,000-square-foot unit includes 33 recliners and 11 private rooms. Or, you can also have your infusion treatments at the Kendall and Deerfield Beach locations.  

  • Targeted Therapy

    Targeted therapy is designed to attack the molecular changes that make cancer cells grow and spread. Targeted therapies are available for select patients, as recommended by your Sylvester oncologist.

  • Immunotherapy (Biologic Therapy)  

    This approach helps boost the body's natural defenses to fight cancer.

Tests


In addition to a thorough medical history and physical examination, procedures for diagnosing gallbladder or bile duct cancer may include the following procedures:

  • Blood Tests 

    • Liver function or enzyme tests: A blood test to detect inflammation or damage to the liver caused by gallbladder cancer.

    • Carcinoembryonic Antigen (CEA) and CA 19-9 Assays: These tests gauge the level of CEA and CA 19-9 in the blood, which are substances released into the bloodstream from cancer cells and healthy cells. When found in higher rates, it can be a sign of gallbladder cancer or a non-cancerous condition.

  • Imaging Tests 

    • Ultrasound: TUses sound waves and a computer to produce pictures of tissues, blood vessels, and organs. Ultrasound images help your doctor evaluate the function of your internal organs and observe blood flow through various vessels.

    • Computed tomography (CT or CAT scan): Uses a combination of X-rays and computer technology to produce horizontal, or axial, images of pelvic organs that are more detailed than general X-rays.

    • Magnetic resonance imaging (MRI): Uses large magnets, radio waves, and a computer to create images of structures and organs in your body.

    • Positron emission tomography (PET scan): A small amount of radioactive glucose (sugar) is injected into a vein before a scan to highlight any cancerous cells. The cancer cells “light up” because they use more glucose for energy.

    • Cholangiopancreatography: X-ray procedures that allow your doctor to look for blockages, take samples (biopsies), or treat problems in your bile ducts. Endoscopic retrograde cholangiopancreatography uses an endoscope (a flexible, lighted tube) inserted down your throat and into your bile ducts. Percutaneous transhepatic cholangiography uses contrast dye that’s injected into your liver to make structures easier to see.

Accepted Insurances

Note: Health plans that are currently contracted with UHealth are listed below. However, please check with your insurance provider to verify that UHealth is part of your provider network.

Accepted Insurance