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The gallbladder and bile ducts make up a part of the body called the biliary system. This system is shaped like a tree. The small branches located at the top of the tree are actually inside the liver. The liver makes bile, which is a liquid that helps your intestines digest fats and vitamins. The small branches converge to form larger branches and eventually they converge to form a single trunk. This trunk is a large tube that carries the bile out of the liver and down to the intestine, where it can mix with the food you eat. When you are not eating, excess bile is stored in the gallbladder. You can think of this as a tree house located on the lowest branch of the biliary tree. When you eat your next meal, the gallbladder squeezes and the extra bile is released back in to the intestine.
Gallbladder cancer occurs when damage to the gallbladder causes mutations in its DNA at the cellular level. This leads to the formation of a mass that can be cancerous. Likewise, a bile duct cancer occurs when the biliary tree is damaged at the cellular level. Bile duct cancers can occur anywhere within the biliary tree. Some bile duct cancers start in the small branches located within the liver. Other bile duct tumors start in the trunk of the tree, outside of the liver and closer to the intestine.
Gallbladder and bile duct cancers are extremely rare but when they occur it is important that you are treated by an institution that is experienced in managing these cancers. Despite the relative rarity of these cancers, TriHealth actually sees a large volume of gallbladder and bile duct cancer patients. At TriHealth, your care will be delivered by a multidisciplinary team of experts working together to develop a personalized treatment plan.
Cancers of the gallbladder and bile ducts are rare and may be difficult to diagnose. These cancers may be fairly asymptomatic but when symptoms do occur, the symptoms are often related to the location of the tumor. Cholecystitis or gallbladder pain can occur when the tumor is located in the gallbladder. Similar pain can occur with tumors in the biliary tree. Yellowing of the skin known as jaundice can occur when the tumor is located in the main trunk of the biliary tree. In addition to symptoms, gallbladder and bile duct cancers can cause some blood work abnormalities. These labs are routinely checked on annual physical exams and so it is very important to see your primary care physician and get this blood work done on an annual basis.
Treatment of gallbladder and bile duct cancers can vary based on the location of the tumor. Treatment often involves a combination of methods that can include chemotherapy, surgery, radiation and/or procedures performed by interventional radiology to provide therapy to the liver directly through blood vessels that enter or exit the liver. At TriHealth, a multidisciplinary team of specialists with the consideration of each individual patient determines the specific method or methods of treatment used.
At TriHealth, we believe in a multidisciplinary approach to treating gallbladder and bile duct cancers. This means coordination of your care to include multiple specialists working together for one common goal – you. This multidisciplinary care starts at the time of your diagnosis. Your GI or primary care physician will notify our nurse navigator. The nurse navigator will then schedule you an appointment in our pancreatic cancer multidisciplinary clinic and schedule any additional tests that you may need prior to your office visit. In our multidisciplinary clinic you will meet with multiple specialists who will be involved in your care. This will likely include a medical oncologist, a radiation oncologist and a surgical oncologist. We also have nutritionists and licensed genetic councilors available at this appointment. Together, these specialists will develop a comprehensive treatment plan for you.
Surgery can be an important part of treating gallbladder and pancreatic cancer. The specific surgical procedure depends on the location of the tumor. Gallbladder cancer surgery often requires removal of the gallbladder as well as part of the liver and the surrounding lymph nodes. Bile duct cancers surgeries vary depending on location and can involve a liver resection the tumor is located in the liver or a Whipple procedure if the tumor is located closer to the pancreas. TriHealth surgeons have specialized training to perform these surgeries and when appropriate, can even perform these surgeries in a minimally invasive fashion using robotic surgical techniques. In fact TriHealth is a leader in the use of robotic technology to perform complex surgical procedures in a minimally invasive fashion that would otherwise be performed through large open incisions at other institutions.