Print Hilar cholangiocarcinoma 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. Hilar cholangiocarcinoma is a type of bile duct cancer that occurs in the bile ducts that lead out of the liver (hepatic ducts) and join with the gallbladder. Hilar cholangiocarcinomas are also known as Klatskin tumors. DiagnosisTests and procedures used to diagnose hilar cholangiocarcinoma include: Imaging tests, such as computerized tomography (CT) and magnetic resonance imaging (MRI) Blood test for very high levels of the CA 19-9 tumor marker Biopsy using endoscopic retrograde cholangiopancreatography (ERCP) or endoscopic ultrasound and specialized lab testing with fluorescence in situ hybridization (FISH) Doctors typically don't recommend collecting cells using a needle inserted through your skin and into your bile duct (transperitoneal biopsy). This technique increases the risk of cancer recurrence and may make you ineligible for a liver transplant. TreatmentWhich treatment is best for you will depend on the location and extent of your hilar cholangiocarcinoma. Treatment typically involves surgery, liver transplant or supportive treatments to reduce your pain and other symptoms. SurgerySurgery for hilar cholangiocarcinoma involves removing: The cancer Surrounding bile ducts Portions of the liver Nearby lymph nodes The surgeon then connects the remaining bile ducts to the small intestine so that bile can still reach your digestive tract and help digest food. Liver transplantSome people with early-stage hilar cholangiocarcinoma may consider liver transplant. Chemotherapy and radiation are typically used before the liver transplant to kill as many cancer cells as possible before surgery. This treatment typically involves: Intravenous chemotherapy with a medicine that makes your cells more vulnerable to radiation External beam radiation therapy Internal radiation (brachytherapy) using small wires that are placed near the cancer and slowly release radiation Chemotherapy in pill form until transplant surgery Minimally invasive surgery to look for signs that cancer has spread Liver transplant with a donor liver if one becomes available You may undergo routine tests to evaluate your health while waiting for a liver transplant to make sure you're healthy enough for the surgery. ChemotherapyPeople with advanced hilar cholangiocarcinoma who aren't able to undergo surgery or liver transplant may receive chemotherapy to slow the growth of the cancer. By Mayo Clinic Staff Request an appointment 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? 356 Replies Sat, Oct 26, 2024 chevron-right Liver disease itching: What helps? 157 Replies Fri, Oct 04, 2024 chevron-right Double lung transplant 13 Replies Sun, Sep 15, 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. Hepatobiliary cancers. National Comprehensive Cancer Network. https://www.nccn.org/professionals/physician_gls/default.aspx. Accessed Jan. 14, 2021. 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. Anderson CD, et al. Treatment options for locally advanced, unresectable, but nonmetastatic cholangiocarcinoma. https://www.uptodate.com/contents/search. Accessed Feb. 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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