What is bile duct cancer?

The bile ducts are part of the digestive system Open a glossary item. They are tubes that carry bile. This is a fluid that helps your body digest food. 

Bile duct cancer is when abnormal cells in the bile ducts divide in an uncontrolled way. The cells can spread into surrounding healthy tissues or organs, like the bowel or pancreas. They may also spread to parts of the body away from the bile duct. 

Bile duct cancer is also called cholangiocarcinoma (pronounced kol-an-gee-oh-car-sin-oh-ma). 

This video shows where the bile ducts are, what they do and the different areas where bile duct cancer can develop. The video is 1 minute and 30 seconds long. 

The bile ducts

Bile ducts carry bile from your liver, where it is made, to your gallbladder where it is stored.

When you eat, your gallbladder releases bile back into the bile ducts. It flows to the small bowel where it breaks down fat in the food you've eaten. This makes it easier for your body to use the food. 

Diagram showing the position of the gallbladder and bile ducts

There two main bile ducts in the liver. These are the:

  • right hepatic duct
  • left hepatic duct

They join together just outside the liver to make the common hepatic duct. Bile flows down this duct and into the cystic duct. This is connected to the gallbladder.

Diagram showing the position of the bile ducts

When we eat, bile is released from the gallbladder back into the cystic duct. It then flows down the common bile duct.

Before it gets to the small bowel, the common bile duct joins the pancreatic duct. This releases pancreatic juice which also breaks down food to make it easier to use.

Where bile duct cancer develops

Doctors divide bile duct cancer into 3 groups depending on where it starts:

  • intrahepatic bile duct cancers

  • perihilar bile duct cancers

  • distal bile duct cancers

Diagram showing the groups of bile ducts

Intrahepatic bile duct cancer

Starts in the bile ducts inside the liver.

Intrahepatic bile duct cancer is also called intrahepatic cholangiocarcinoma.

Perihilar bile duct cancer

Starts in the bile ducts just outside the liver, but before the cystic duct joins the common hepatic duct.

Perihilar bile duct cancer is also called a Klatskin tumour or hilar cancer.

Distal bile duct cancer

Starts in the bile ducts below where the cystic duct joins the common hepatic duct. 

Who gets bile duct cancer?

Anything that can increase your risk of cancer is called a risk factor. Having one or more risk factors doesn’t mean you'll definitely get bile duct cancer.

Bile duct cancer is more common in older people. The risk is also higher in people who have:

  • inflammation in their bile ducts called primary sclerosis cholangitis (PSC)
  • a rare type of cyst Open a glossary item in their bile ducts called a choledochal cyst
  • stones in their bile ducts or gallbladder - these are made from tiny amounts of fats and bilirubin Open a glossary item

Some other risk factors can depend on which bile duct the cancer is in and where in the world you live.

How common is bile duct cancer?

In the UK, around 3,100 people are diagnosed with bile duct cancer each year. 

The number of people getting bile duct cancer has increased in the last few years. Researchers don't know for sure what's causing the number to increase. Some studies suggest it might be related to lifestyle choices such as smoking and drinking alcohol. 

  • Biliary tract cancer: ESMO Clinical Practice Guideline for diagnosis, treatment and follow up
    A Vogel and others
    Annals of Oncology, 2023. Volume 34, Issue 2, Pages 127–140

  • Ross and Wilson Anatomy and Physiology in Health and Illness (14th edition)
    A Waugh and A Grant
    Elsevier Ltd, 2023

  • AJCC Cancer Staging Manual (8th edition)
    American Joint Committee on Cancer,
    Springer, 2017

  • Cholangiocarcinoma: Epidemiology and risk factors
    SA Khan and others
    Liver International 2019. Volume 39, Issue S1 - Special Issue: Cholangiocarcinoma, Pages 19-31

  • Risk factors for intrahepatic and extrahepatic cholangiocarcinoma: A systemic review and meta-analysis
    O Clements and others
    Journal of Hepatology, 2020. Volume 72, Pages 95-103

  • The information on this page is based on literature searches and specialist checking. We used many references and there are too many to list here. Please contact patientinformation@cancer.org.uk with details of the particular issue you are interested in if you need additional references for this information.

Last reviewed: 
20 Jun 2024
Next review due: 
20 Jun 2027

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