How is cholangiocarcinoma diagnosed?
Your healthcare provider evaluates your symptoms, reviews your medical history and does a physical exam. Tests for cholangiocarcinoma may include:
- Liver function tests: These liver tests check your blood for high levels of substances that might indicate your liver isn’t working as it should or there is a bile duct blockage, such as elevated liver enzymes.
- Tumor marker tests: These tests check your blood or urine for proteins and other substances that could mean you have cancer.
- Abdominal ultrasound: An abdominal ultrasound uses sound waves to create pictures of your liver, pancreas and gallbladder. This may be the first imaging exam you have if your healthcare provider suspects bile duct cancer.
- Magnetic resonance cholangiopancreatography (MRCP): MRCP is a specialized imaging exam that uses an MRI machine. It creates detailed pictures of the liver, bile ducts, gallbladder, pancreas and pancreatic duct.
- Endoscopic retrograde cholangiopancreatography (ERCP): ERCP uses an endoscope and a catheter (thin, flexible tubes) to examine your bile ducts. The endoscope goes into your mouth and down to your small intestine while you’re sedated (in a light sleep). The catheter delivers contrast dye to outline the shape of your bile ducts on X-rays. If you have a bile duct blockage, a stent device can be placed during an ERCP in the blocked bile duct to open it back up.
- Percutaneous transhepatic cholangiography (PTC): A PTC creates X-rays of your bile ducts like an ERCP. But instead of an endoscope and catheter, your healthcare provider delivers contrast dye by inserting a needle directly into your bile ducts and liver. A PTC is usually only for people who can’t have an ERCP.
If imaging and lab tests indicate cancer, your healthcare provider will perform a biopsy. A biopsy is a procedure to take a sample of tissue from your body. A pathologist examines the tissue under a microscope in a laboratory to check for cancer. Your healthcare provider can take bile duct tissue samples during an ERCP, PTC or by using a small needle through the skin.