Your Journey Starts Here

A diagnosis of a biliary tumor can be difficult and complex to understand and navigate. Our mission is to stand by you and walk with you every step of the way. While every patient’s journey is different, and may start at different paths, a typical journey consists of:
  • Referral

    Occurs when your regular doctors identify the need to consult with our Institute and refer you to us.

  • Workup

    Includes all the labs, imaging studies, and procedures required to make a diagnosis.

  • Tumor Board

    A discussion about your care held by your treatment team at our Institute. After discussion, a recommendation is made about treatment options.

  • Treatment

    Can include a variety of treatments customized to you! Typical treatments include surgery, chemotherapy, radiation, or clinical trial.

  • Surveillance

    Occurs after treatment is complete, and usually consists of imaging studies, labs, and examinations to make sure you are treated.

Understanding Your Biliary Tree

Your gallbladder and bile ducts are located in your right upper abdomen. The bile duct and hepatic ducts (biliary system), transport bile from your liver into the intestine. Bile helps with digesting fat. The gallbladder stores bile.

Problems With Your Gallbladder and Biliary System

Cholecystitis and Cholangitis

Cholecystitis is the inflammation and infection of the gallbladder, which occurs in some patients with gallstones . Cholangitis is an infection of the bile duct, which can occur, when the bile duct is blocked by a gallstone.

What are cholecystitis and cholangitis?

Cholecystitis is the inflammation and infection of the gallbladder, which occurs in some patients with gallstones . Cholangitis is an infection of the bile duct, which can occur, when the bile duct is blocked by a gallstone.

What are the signs and symptoms of cholecystitis and cholangitis?

Cholecystitis and cholangitis can present with fevers, chills, low blood pressure and pain in the right upper abdomen. If the bile duct is blocked with a gallstone, the patient might also have jaundice (yellowing of the eyes and skin).

Why do I get cholecystitis and cholangitis?

Cholecystitis and cholangitis can present with fevers, chills, low blood pressure and pain in the right upper abdomen. If the bile duct is blocked with a gallstone, the patient might also have jaundice (yellowing of the eyes and skin).

How are Cholecystitis and Cholangitis diagnosed?

If you have symptoms of cholecystitis or cholangitis, your doctor may order blood tests or scans of your abdomen. Sometimes you may also need a procedure.

Blood tests

Imaging

Procedures

How is Cholecystitis and Cholangitis treated?

Hospital Admission

Patients with Cholecystitis and Cholangitis will be admitted to the hospital, and treated with intravenous fluids, antibiotics and pain medications.

Surgery and Procedures for Cholecystitis and Cholangitis

Patients with Cholecystitis need to have their gallbladder removed surgically ( cholecystectomy ). Patients with cholangitis will have an endoscopic procedure called ERCP to remove the gallstone from the bile duct. Since the gallbladder is the most likely source of gallstones, patients will need a cholecystectomy after their acute cholangitis has resolved.

Gallbladder and Bile Duct Cancer

Gallbladder cancer is a cancer in that occurs in the wall of the gallbladder. Bile duct cancer (cholangiocarcinoma) arises from the wall of the liver ducts. It can occur in the liver or in the ducts connecting the liver to the intestine.

What is gallbladder and bile duct cancer?

Gallbladder cancer is a cancer in that occurs in the wall of the gallbladder. Bile duct cancer (cholangiocarcinoma) arises from the wall of the liver ducts. It can occur in the liver or in the ducts connecting the liver to the intestine.

There are 3 different types of cholangiocarcinoma:

What are the signs and symptoms of gallbladder and bile duct cancer?

Gallbladder and bile duct cancer is often silent in early stages. Patients may present with:
More advanced stages can present with:

What is my risk for getting gallbladder and bile duct cancer?

Increased risk for gallbladder cancer

Gallbladder cancer is more common in older women.

Increased risk for bile duct cancer (cholangiocarcinoma)

How is gallbladder and bile duct cancer diagnosed?

If you have any symptoms of gallbladder or bile duct cancer, your doctor may order blood tests and pictures (imaging) of your belly. You may also need a biopsy to confirm the diagnosis.

Blood tests

Imaging

Procedures

How is gallbladder and biliary cancer treated?

The treatment of gallbladder and bile duct cancer depends on the stage of the tumor, and involves a multidisciplinary team of doctors, nurses and medical support staff:
Every patient seen here will be presented in our Multidisciplinary Tumor Board , where we will devise your individual treatment plan. This plan may include:
We strongly encourage and support all of our patients to participate in clinical trials. We are happy to talk to you about clinical trials during your clinic visit.

Bile Duct (Choledochal) Cysts

Bile duct cysts are abnormalities in the tubes connecting liver to the intestine. The bile ducts enlarge like balloons anywhere along their course towards the small bowel. There are different types of bile duct cysts, depending on where the ballooning occurs.

What are choledochal (bile duct) cysts?

Bile duct cysts are abnormalities in the tubes connecting liver to the intestine. The bile ducts enlarge like balloons anywhere along their course towards the small bowel. There are different types of bile duct cysts, depending on where the ballooning occurs.

What are the signs and symptoms of bile duct cysts?

Choledochal cysts are usually diagnosed in children, but sometimes not recognized until adulthood. The may present as:

What are my risks for having bile duct cysts?

Bile duct cysts are congenital, which means that they have been present since birth, and might not get recognized until adulthood.
They can cause repeated infection and can turn into cancer.

How are bile duct cysts diagnosed?

If you have any symptoms of a bile duct cyst, your doctor may order blood tests and pictures (imaging) of your belly. You may also need a biopsy to confirm the diagnosis

Blood tests

Imaging

Procedures

How are bile duct cysts treated?

Bile ducts cysts will always be removed with surgery. The type of surgery depends on the location of the cyst.
If the cyst is the part of the bile duct outside the liver and pancreas, the patient will need a bile duct excision and reconstruction .
If the bile duct cyst is not part of the main bile duct, it will be removed without removing and reconstructing the main bile duct.
If the cyst is in the part of the bile duct, which runs through the pancreas, the patient will need a Whipple Procedure .