Carcinoma of the biliary tract

Abstract

The gallbladder and bile ducts share a common embryologic origin and are lined with a simple columnar epithelium. Most malignancies of the biliary tract are adenocarcinomas that arise from the malignant transformation of this columnar epithelium. Adenocarcinomas of the bile ducts are often referred to as cholangiocarcinomas. Malignant transformation can occur anywhere along the biliary system from the ampulla of Vater to the terminal intrahepatic bile ducts. Gallbladder cancers arise from the epithelium of the gallbladder or cystic duct. Intrahepatic cholangiocarcinoma (ICC) develops in bile ducts within the liver and proximal to the lobar hepatic ducts and hepatic duct confluence. Extrahepatic bile duct cancer develops in the biliary tree from the ampulla of Vater to the hepatic duct confluence. Extrahepatic bile duct tumors can be further subdivided into intrapancreatic cholangiocarcinoma, which are managed similarly to other periampullary malignancies (and are not discussed here), and proximal or hilar cholangiocarcinoma. © 2011 Springer-Verlag Berlin Heidelberg.