Print Overview Gallbladder and bile duct Enlarge image Close Gallbladder and bile duct Gallbladder and bile duct The gallbladder holds a yellow-green fluid that the liver makes, called bile. Bile flows from the liver into the gallbladder. It stays in the gallbladder until needed to help digest food. During eating, the gallbladder releases bile into the bile duct. The duct carries the bile to the upper part of the small intestine, called the duodenum, to help break down fat in food. Cholangiocarcinoma is a type of cancer that forms in the slender tubes (bile ducts) that carry the digestive fluid bile. Bile ducts connect your liver to your gallbladder and to your small intestine. Cholangiocarcinoma, also known as bile duct cancer, occurs mostly in people older than age 50, though it can occur at any age. Doctors divide cholangiocarcinoma into different types based on where the cancer occurs in the bile ducts: Intrahepatic cholangiocarcinoma occurs in the parts of the bile ducts within the liver and is sometimes classified as a type of liver cancer. Hilar cholangiocarcinoma occurs in the bile ducts just outside of the liver. This type is also called perihilar cholangiocarcinoma. Distal cholangiocarcinoma occurs in the portion of the bile duct nearest the small intestine. This type is also called extrahepatic cholangiocarcinoma. Cholangiocarcinoma is often diagnosed when it's advanced, making successful treatment difficult to achieve.Products & ServicesA Book: Mayo Clinic Family Health BookNewsletter: Mayo Clinic Health Letter — Digital EditionShow more products from Mayo Clinic Types Hilar cholangiocarcinoma SymptomsSigns and symptoms of cholangiocarcinoma include: Yellowing of your skin and the whites of your eyes (jaundice) Intensely itchy skin White-colored stools Fatigue Abdominal pain on the right side, just below the ribs Losing weight without trying Fever Night sweats Dark urine When to see a doctorSee your doctor if you have persistent fatigue, abdominal pain, jaundice, or other signs and symptoms that bother you. He or she may refer you to a specialist in digestive diseases (gastroenterologist). Request an appointment There is a problem with information submitted for this request. Review/update the information highlighted below and resubmit the form. 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If we combine this information with your protected health information, we will treat all of that information as protected health information and will only use or disclose that information as set forth in our notice of privacy practices. You may opt-out of email communications at any time by clicking on the unsubscribe link in the e-mail. Thank you for subscribing Your in-depth coping with cancer guide will be in your inbox shortly. You will also receive emails from Mayo Clinic on the latest about cancer news, research, and care. If you don’t receive our email within 5 minutes, check your SPAM folder, then contact us at newsletters@mayoclinic.com. Sorry something went wrong with your subscription Please, try again in a couple of minutes Retry CausesCholangiocarcinoma happens when cells in the bile ducts develop changes in their DNA. A cell's DNA contains the instructions that tell a cell what to do. The changes tell the cells to multiply out of control and form a mass of cells (tumor) that can invade and destroy healthy body tissue. It's not clear what causes the changes that lead to cholangiocarcinoma. Risk factorsFactors that may increase your risk of cholangiocarcinoma include: Primary sclerosing cholangitis. This disease causes hardening and scarring of the bile ducts. Chronic liver disease. Scarring of the liver caused by a history of chronic liver disease increases the risk of cholangiocarcinoma. Bile duct problems present at birth. People born with a choledochal cyst, which causes dilated and irregular bile ducts, have an increased risk of cholangiocarcinoma. A liver parasite. In areas of Southeast Asia, cholangiocarcinoma is associated with liver fluke infection, which can occur from eating raw or undercooked fish. Older age. Cholangiocarcinoma occurs most often in adults over age 50. Smoking. Smoking is associated with an increased risk of cholangiocarcinoma. Diabetes. People who have type 1 or 2 diabetes may have an increased risk of cholangiocarcinoma. Certain inherited conditions. Some DNA changes passed from parents to children cause conditions that increase the risk of cholangiocarcinoma. Examples of these conditions include cystic fibrosis and Lynch syndrome. PreventionTo reduce your risk of cholangiocarcinoma, you can: Stop smoking. Smoking is linked to an increased risk of cholangiocarcinoma. If you smoke, stop. If you have tried quitting in the past and haven't been successful, talk with your doctor about strategies to help you quit. Reduce your risk of liver disease. Chronic liver disease is associated with an increased risk of cholangiocarcinoma. Some causes of liver disease can't be prevented, but others can. Do what you can to take care of your liver. For instance, to reduce your risk of liver inflammation (cirrhosis), drink alcohol in moderation, if you choose to drink. For healthy adults, that means up to one drink a day for women and up to two drinks a day for men. Maintain a healthy weight. When working with chemicals, follow the safety instructions. By Mayo Clinic Staff Cholangiocarcinoma (bile duct cancer) care at Mayo Clinic Request an appointment Diagnosis & treatment June 06, 2023 Print Living with cholangiocarcinoma (bile duct cancer)? Connect with others like you for support and answers to your questions in the Transplants support group on Mayo Clinic Connect, a patient community. Transplants Discussions Transplant anti-rejection medications. What's your advice? 368 Replies Sun, Dec 08, 2024 chevron-right Anyone waiting for liver transplant and diagnosed with liver cancer? 37 Replies Fri, Dec 06, 2024 chevron-right Liver transplant - Let's support each other 1618 Replies Tue, Dec 03, 2024 chevron-right See more discussions Show references AskMayoExpert. Cholangiocarcinoma (adult). Mayo Clinic; 2020. Feldman M, et al., eds. Tumors of the bile ducts, gallbladder and ampulla. In: Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. 11th ed. Elsevier; 2021. https://www.clinicalkey.com. Accessed Jan. 14, 2021. Bile duct cancer (cholangiocarcinoma). Cancer.Net. https://www.cancer.net/cancer-types/bile-duct-cancer/view-all. Accessed April 6, 2021. Hepatobiliary cancers. National Comprehensive Cancer Network. https://www.nccn.org/guidelines/guidelines-detail?category=1&id=1438. Accessed Jan. 14, 2021. Choi J, et al. Aspirin use and the risk of cholangiocarcinoma. Hepatology. 2016; doi:10.1002/hep.28529. Banales JM, et al. Cholangiocarcinoma 2020: The next horizon in mechanisms and management. Nature Reviews Gastroenterology & Hepatology. 2020; doi:10.1038/s41575-020-0310-z. Bile duct cancer (cholangiocarcinoma) treatment — Health professional version (PDQ). National Cancer Institute. https://www.cancer.gov/types/liver/hp/bile-duct-treatment-pdq. Accessed April 6, 2021. Lowe RC, et al. Clinical manifestations and diagnosis of cholangiocarcinoma. https://www.uptodate.com/contents/search. Accessed April 6, 2021. Anderson CD. Surgical resection of localized cholangiocarcinoma. https://www.uptodate.com/contents/search. Accessed April 6, 2021. Bergquist JR, et al. Implications of CA-19 elevation for survival, staging, and treatment sequencing in intrahepatic cholangiocarcinoma: A national cohort analysis. Journal of Surgical Oncology. 2016; doi:10.1002/jso.24381. Lavu S, et al. Effect of statins on the risk of extrahepatic cholangiocarcinoma. 2020; doi:10.1002/hep.31146. Rea DJ, et al. Liver transplantation with neoadjuvant chemoradiation is more effective than resection for Hilar cholangiocarcinoma. 2005; doi:10.1097/01.sla.0000179678.13285.fa. Giridhar KV (expert opinion). Mayo Clinic. May 4, 2021. Petrick JL, et al. Risk factors for intrahepatic and extrahepatic cholangiocarcinoma in the United State: A population-based study in SEER-Medicare. PLoS ONE. 2017; doi:10.1371/journal.pone.0186643. Yamada A, et al. Risk of gastrointestinal cancers in patients with cystic fibrosis: A systematic review and meta-analysis. Lancet Oncology. 2018; doi:10.1016/S1470-2045(18)30188-8. Genetic/familial high-risk assessment: Colorectal. National Comprehensive Cancer Network. https://www.nccn.org/guidelines/guidelines-detail?category=2&id=1436. Accessed May 28, 2021. Related Biliary tract cancer: Should I get a second opinion? Endoscopic ultrasound Is a clinical trial for biliary tract cancer right for me? Palliative care for biliary tract cancer Precision medicine: A new way to treat biliary cancers Treatment options for biliary tract cancer What is biliary tract cancer? Show more related content Associated Procedures Chemotherapy CT scan Liver function tests Liver transplant MRI Needle biopsy Palliative care Photodynamic therapy Radiation therapy Show more associated procedures News from Mayo Clinic Research fuels advances in bile duct cancer care Jan. 13, 2024, 12:00 p.m. CDT Mayo Clinic Q and A: What is cholangiocarcinoma and how is it treated? Feb. 21, 2023, 04:00 p.m. CDT Products & Services A Book: Mayo Clinic Family Health Book Newsletter: Mayo Clinic Health Letter — Digital Edition Show more products and services from Mayo Clinic Cholangiocarcinoma (bile duct cancer)Symptoms&causesDiagnosis&treatmentDoctors&departmentsCare atMayoClinic Advertisement Mayo Clinic does not endorse companies or products. Advertising revenue supports our not-for-profit mission. Advertising & Sponsorship Policy Opportunities Ad Choices Mayo Clinic Press Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press. 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There is a problem with information submitted for this request. Review/update the information highlighted below and resubmit the form. Get Mayo Clinic cancer expertise delivered to your inbox. Subscribe for free and receive an in-depth guide to coping with cancer, plus helpful information on how to get a second opinion. You can unsubscribe at any time. Click here for an email preview. Email address I would like to learn more about Up-to-date cancer news & research Mayo Clinic cancer care & management options ErrorSelect a topic ErrorEmail field is required ErrorInclude a valid email address Address 1 Subscribe Learn more about Mayo Clinic’s use of data. To provide you with the most relevant and helpful information, and understand which information is beneficial, we may combine your email and website usage information with other information we have about you. If you are a Mayo Clinic patient, this could include protected health information. If we combine this information with your protected health information, we will treat all of that information as protected health information and will only use or disclose that information as set forth in our notice of privacy practices. You may opt-out of email communications at any time by clicking on the unsubscribe link in the e-mail. Thank you for subscribing Your in-depth coping with cancer guide will be in your inbox shortly. You will also receive emails from Mayo Clinic on the latest about cancer news, research, and care. If you don’t receive our email within 5 minutes, check your SPAM folder, then contact us at newsletters@mayoclinic.com. Sorry something went wrong with your subscription Please, try again in a couple of minutes Retry