What examination items are needed for bile duct cancer

Cholangiocarcinoma, a type of cancer, brings a devastating blow to our lives and work. The impact is so great that we are unwilling to accept it and we cannot afford to ignore it. So in daily life, if we encounter bile duct cancer, what should we do? Next, let us understand what examinations are needed for bile duct cancer.

Examination items: fecal occult blood test, blood test, B-ultrasound, CT, endoscopic ultrasound (EUS), percutaneous transhepatic cholangiography (PTC), retrograde cholangiopancreatography (ERCP), fiberoptic choledochoscopy, selective angiography (SCAG) and transhepatic portal vein angiography (PTP), magnetic resonance pancreatocholangiography

1. Laboratory examination

Total bilirubin, direct bilirubin, alkaline phosphatase and γ-glutamyl transferase may be significantly elevated. Transaminases are generally mildly abnormal. This imbalance of bilirubin and transaminases helps to differentiate from viral hepatitis. Prothrombin time is prolonged, and CA199 and CEA may be elevated in some patients.

2. Imaging examination

Imaging examinations can help to confirm the diagnosis of cholangiocarcinoma, understand the presence of metastatic lesions, and assess whether the tumor can be removed.

(1) Ultrasound imaging

Ultrasound examination is simple, fast, accurate and inexpensive, and can detect: ① dilatation of the intrahepatic and extrahepatic bile ducts; ② the site of obstruction in the bile duct; ③ the nature of the obstruction. Ultrasound examination is the preferred examination for obstructive jaundice.

(2) Percutaneous transhepatic cholangiography (PTC)

PTC can clearly show the morphology, distribution and obstruction site of the intrahepatic and extrahepatic bile duct trees. This examination is an invasive operation, and postoperative bleeding and bile leakage are common and serious complications.

(3) Endoscopic retrograde cholangiopancreatography (ERCP)

ERCP should not be used as a routine examination for bile duct cancer, and is even relatively contraindicated. For high-positioned bile duct cancer, percutaneous transhepatic cholangiography can show the location of the bile duct cancer, and an internal support catheter can also be placed to reduce jaundice. ERCP has diagnostic significance for lower bile duct cancer and helps to differentiate it from duodenal papillary tumors and pancreatic head cancer.

(4) CT examination

CT can more accurately display the location and range of bile duct dilatation and obstruction, and has a high accuracy in determining the nature of lesions. Three-dimensional spiral CT cholangiography (SCTC) has a tendency to replace PTC and ERCP examinations.

(5) Magnetic resonance cholangiopancreatography (MRCP)

MRCP examination is a non-invasive biliary imaging technology that can show in detail the overall picture of the intrahepatic bile duct tree, the location and range of tumor obstruction, and the presence or absence of liver parenchymal invasion or liver metastasis. It is currently the ideal imaging examination method for hilar cholangiocarcinoma.

(6) Radionuclide imaging scan

By injecting 99 millimeters of technetium EHIDA intravenously and then taking continuous photos with a gamma camera, dynamic images of the bile duct can be obtained. This method is simple and harmless to the patient.

(7) Selective hepatic arteriography and portal venography

The main purpose is to understand the relationship between the portal vein and hepatic artery and the tumor, as well as the extent of invasion, to help evaluate the resectability of the tumor before surgery. I hope these examination methods for bile duct cancer will be helpful to everyone.