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Gallbladder and Bile Ducts: Small Organs with Big Responsibilities

Tue, 02/09/2021 - 08:00

woman in white shirt touching the side of her abdomen

New Brunswick, N.J., February 9, 2021 – Unless you or a loved one has been diagnosed with cancer of the gallbladder or bile duct, you may not be familiar with these parts of the digestive system. Gallbladder cancer and bile duct cancers are rare, which is why it is important to learn the signs and symptoms of these diseases and help spread awareness. 


The Gallbladder

The gallbladder is a small organ that is connected to the liver by the bile ducts. The function of this organ is to store bile, a substance produced by the liver to aid in the digestion of dietary fats. When cancer develops in the gallbladder, it usually begins within the innermost layers and then gradually spreads to the surrounding tissues. This type of cancer can be difficult to detect early or during a routine physical exam because the gallbladder is a tiny organ that is largely concealed by the liver. 

While gallbladder cancer usually does not cause symptoms until later in the course of the disease, sometimes initial signs do appear. Some of these include lumps in the belly, nausea and/or vomiting, abdominal pains, weight loss, and jaundice late in the disease process.
 

Bile Ducts

Bile ducts are a series of thin tubes (ducts) that transfer bile fluid from the liver to the small intestine. Their main function is to help digest the fats in food.

Bile duct cancer, also known as cholangiocarcinoma, is caused by the abnormal growth of cells in the bile duct that can occur in any portion of the biliary ductal system. Bile duct cancer is divided into three classes according to the location where it occurs:

  • Intrahepatic cholangiocarcinoma: Originates in the smaller branches within the liver
  • Perihilar cholangiocarcinoma (Klatskin tumor): Originates outside the liver where the right and left hepatic ducts meet
  • Distal cholangiocarcinoma: Originates further down in the bile duct, stretching between the pancreas and small intestine

People who have chronic inflammation of the bile ducts have an increased risk of developing bile duct cancer, along with people with inflammatory bowel disease and people of older age. Some symptoms of bile duct cancer include jaundice, itching, dark urine, abdominal pain, fever, nausea, and vomiting.

Currently, there are certain pathologies of the gallbladder and biliary system which can be precursors to malignancy such gallbladder polyps, choledochal cysts, and biliary cystadenoma.  In these situations, surgical resection is recommended generally as a preventative measure.

Research

Advancements in the treatment of these cancers have been primarily in the systemic therapies, such as immunotherapy and target therapy, which are offered to patients at Rutgers Cancer Institute of New Jersey and RWJBarnabas Health. In addition, we are now offering most patients with these disease processes systemic therapy after surgery based on recent clinical trials.  These clinical trials for systemic chemotherapy for gallbladder cancer and bile duct cancers are also available at Rutgers Cancer Institute and RWJBarnabas Health.  In addition, we are in the process of becoming part of a surgical clinical trial for these disease processes.

Learn more about the Liver Cancer and Bile Duct Cancer Program, the state's only multidisciplinary healthcare group focused on liver and bile duct tumors: https://www.cinj.org/patient-care/liver-cancer-and-bile-duct-cancer-program
 

Miral Sadaria Grandhi, MD is a surgical oncologist in the Liver Cancer and Bile Duct Cancer Program at Rutgers Cancer Institute of New Jersey and is an assistant professor of surgery at Rutgers Robert Wood Johnson Medical School. Dr. Grandhi also sees patients at Robert Wood Johnson University Hospital Somerset, an RWJBarnabas Health facility.
 

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