When viewing this topic in a different language, you may notice some differences in the way the content is structured, but it still reflects the latest evidence-based guidance.

Colangiocarcinoma

Last reviewed: 23 Aug 2025
Last updated: 27 Aug 2025

Summary

Definition

History and exam

Key diagnostic factors

  • presença de fatores de risco
  • icterícia indolor
  • perda de peso
  • dor abdominal
Full details

Other diagnostic factors

  • prurido
  • tríade de febre, icterícia e dor no quadrante superior direito do abdome
  • vesícula biliar palpável
  • hepatomegalia
  • urina escura
  • fezes claras
  • assintomático
Full details

Risk factors

  • idade >50 anos
  • colangite
  • coledocolitíase
  • colecistolitíase
  • outros distúrbios estruturais do trato biliar
  • colite ulcerativa
  • colangite esclerosante primária
  • cirrose inespecífica
  • hepatopatia alcoólica
  • infecção por parasitas hepáticos
  • portador crônico de febre tifoide
  • vírus da hepatite C (HCV)
  • vírus da imunodeficiência humana (HIV)
  • vírus da hepatite B (HBV)
  • exposição ao dióxido de tório
  • diabetes
  • tabagismo
  • exposição a toxinas/medicamentos
  • sexo masculino
Full details

Diagnostic investigations

1st investigations to order

  • bilirrubina sérica
  • fosfatase alcalina sérica
  • gama-glutamiltransferase sérica
  • aminotransferase sérica
  • tempo de protrombina sérica
  • antígeno CA 19-9 sérico
  • antígeno carcinoembriogênico (CEA) sérico
  • antígeno CA-125 sérico
  • ultrassonografia abdominal
  • tomografia computadorizada (TC) abdominal
  • ressonância nuclear magnética (RNM) abdominal
Full details

Investigations to consider

  • ultrassonografia endoscópica (USE)
  • angiografia por ressonância magnética (RM)
  • colangiopancreatografia retrógrada endoscópica (CPRE)
  • colangiopancreatografia por ressonância magnética (CPRM)
  • cateterismo trans-hepático percutâneo (CTP)
  • tomografia por emissão de pósitrons (PET)
  • Imunocoloração
Full details

Emerging tests

  • tomografia de coerência óptica (TCO)
  • colangioscopia peroral
  • colangioscopia assistida por duodenoscópio

Treatment algorithm

ACUTE

doença ressecável

doença irressecável

Contributors

Authors

N. Joseph Espat, MD, MS, FACS

Chairman of Surgery

Professor

Director Cancer Center

Department of Surgery

Roger Williams Medical Center

Boston University School of Medicine

Providence

RI

Disclosures

NJE declares he has no competing interests.

Ponnandai Somasundar, MD, MPH, FACS

Associate Professor and Chief of Surgical Oncology

Department of Surgery

Roger Williams Medical Center

Boston University School of Medicine

Providence

RI

Disclosures

PS declares that he has no competing interests.

Acknowledgements

We would like to acknowledge our Gastroenterology expert panel member, Dr Brooks Cash, for his contribution to this topic.

Disclosures

BC declares that he has no competing interests.

Peer reviewers

Kevin Watkins, MD

Assistant Professor

Department of Surgery

Health Science Center

SUNY

Stony Brook

NY

利益声明

KW declares that he has no competing interests.

Savio Reddymasu, MD

GI Fellow

Department of Medicine

Center for Gastrointestinal Motility

Division of Gastroenterology and Hepatology

University of Kansas Medical Center

Kansas City

KS

利益声明

SR declares that he has no competing interests.

Satvinder Mudan, MBBS, BSc, MD, FRCS

Consultant in Surgical Oncology

The Royal Marsden Hospital

London

UK

利益声明

SM declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

参考文献

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

关键文献

Bridgewater J, Galle PR, Khan SA, et al. Guidelines for the diagnosis and management of intrahepatic cholangiocarcinoma. J Hepatol. 2014;60:1268-1289.全文  摘要

Bowlus CL, Arrivé L, Bergquist A, et al. AASLD practice guidance on primary sclerosing cholangitis and cholangiocarcinoma. Hepatology. 2023 Feb 1;77(2):659-702.全文  摘要

Rushbrook SM, Kendall TJ, Zen Y, et al. British Society of Gastroenterology guidelines for the diagnosis and management of cholangiocarcinoma. Gut. 2023 Dec 7;73(1):16-46.全文  摘要

National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: biliary tract cancers [internet publication].全文

Shroff RT, Kennedy EB, Bachini M, et al. Adjuvant Therapy for Resected Biliary Tract Cancer: ASCO Clinical Practice Guideline. J Clin Oncol. 2019 Apr 20;37(12):1015-1027.全文  摘要

参考文献

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

内容使用需遵循免责声明