Types :-

1. Intrahepatic Cholangiocarcinoma :- Originates in the bile ducts inside the liver.
2. Extrahepatic Cholangiocarcinoma :- Originates in the bile ducts outside the liver and is further divided into :
   • Perihilar (Hilar) Cholangiocarcinoma :- Occurs at the junction where the right and left hepatic bile ducts meet.
   • Distal Cholangiocarcinoma :- Occurs further down the bile duct near the small intestine.

Risk Factors :-

• Primary Sclerosing Cholangitis (PSC) :- A chronic disease causing inflammation and scarring of the bile ducts.
• Chronic Liver Disease :- Such as cirrhosis or hepatitis.
• Bile Duct Abnormalities :- Congenital bile duct cysts or bile duct stones.
• Parasitic Infections :- Liver fluke infections in certain regions.
• Age :- Most common in people over 50.
• Family History :- A family history of bile duct cancer or other biliary diseases.
• Obesity and Diabetes :- Can increase the risk of bile duct cancer.

Symptoms :-

• Jaundice (yellowing of the skin and eyes)
• Itching (pruritus)
• Dark urine
• Pale stools
• Abdominal pain, particularly in the upper right quadrant
• Unexplained weight loss
• Loss of appetite
• Fever
• Fatigue

Diagnosis :-

• Blood Tests :- To check liver function and detect tumor markers (e.g., CA 19-9).
• Imaging Tests :-  Ultrasound, CT scans, MRI, and MRCP (Magnetic Resonance Cholangiopancreatography) to visualize the bile ducts.
• ERCP (Endoscopic Retrograde Cholangiopancreatography) :- A procedure using an endoscope to examine the bile ducts and take biopsy samples.
• PTC (Percutaneous Transhepatic Cholangiography) :- A procedure where contrast dye is injected into the bile ducts to take X-ray images.
• Biopsy :- Removing a small tissue sample for microscopic examination to confirm the diagnosis.

Treatment :-

• Surgery :- The main treatment for early-stage bile duct cancer, often involving the removal of part of the liver, bile ducts, and nearby lymph nodes.
• Liver Transplant :- In some cases, for intrahepatic or perihilar cholangiocarcinoma.
• Radiation Therapy :- Using high-energy rays to kill cancer cells, often used after surgery.
• Chemotherapy :- Using drugs to kill cancer cells or stop them from growing, can be used before surgery (neoadjuvant) or after surgery (adjuvant), and for advanced stages.
• Targeted Therapy :- Drugs that target specific abnormalities in cancer cells.
• Palliative Care :- Focused on relieving symptoms and improving quality of life, especially in advanced stages.

Prognosis :-

• The prognosis for bile duct cancer depends on the stage at which it is diagnosed and the location of the tumor. Early-stage cancers that can be surgically removed have a better prognosis, but overall, bile duct cancer is often diagnosed at an advanced stage, leading to a poorer prognosis.

Prevention :-

• Manage Risk Factors :- Control liver diseases, avoid exposure to liver flukes, and maintain a healthy weight.
• Regular Check-ups :- For individuals with risk factors like PSC or a family history of bile duct cancer.
• Healthy Lifestyle :- Avoid smoking and excessive alcohol consumption.