Bile Duct Cancer

Bile duct illustratiion
Bile Duct Cancer
By Dr. Lee Ser Yee
Bile duct cancer (cholangiocarcinoma) is a rare cancer that begins in the bile ducts. These are thin tubes that carry bile, a brownish digestive fluid, between the liver, gallbladder and small intestine.

Signs and symptoms

Bile duct cancer may not cause symptoms until it reaches an advanced stage. Some people may notice symptoms earlier such as -

  • Yellowing of the skin and eyes (jaundice)
  • Itchy skin
  • Tea-coloured urine and Pale stools
  • Abdominal discomfort, pain or bloatedness
  • Loss of appetite and weight or fatigue

Types of bile duct cancer

These cancers can occur in the main bile duct within the liver (intrahepatic) or outside the liver (extrahepatic)

Risk factors
  • Long-standing inflammation of the bile ducts e.g. liver parasite infections
  • Chronic liver disease (Liver cirrhosis, Hepatitis B & C)
  • Inflammatory conditions e.g. Primary sclerosing cholangitis, ulcerative colitis
  • Bile duct cyst (Choledochal cyst)
  • Drugs or toxins exposure
  • Age ≥ 50; Obesity; Diabetes
  • A full medical history and clinical evaluation
  • Blood Tests - Liver function tests and tumour markers
  • Imaging – CT, MRI or PET scans - for assessment and staging
  • Endoscopy (+/- ultrasound) or Cholangiography- for further evaluations and biopsy
  • Combination of the above


Surgery is the preferred treatment for bile duct cancer that has not spread. This may involve removing the bile duct, portion of the liver and surrounding lymph nodes and involved organs.

Depending on the location and extent of the cancer, the following surgeries may be recommended.

  • Liver Resection
  • Bile duct resection & lymph node clearance
  • Whipple surgery
  • Liver transplant

Other treatments such as radiation or chemotherapy, in addition to surgery or for people when surgery is not appropriate.

Bile duct anatomy illustration
liver surgeon - Dr Lee Ser Yee
Dr Lee Ser Yee

Senior Consultant Hepatopancreatobiliary Surgeon

MBBS, MMed (Surgery), MSc, FAMS, FRCSEd

Prior to private practice, Dr Lee Ser Yee was a founding member and Senior Consultant at the Department of Hepatopancreatobiliary (HPB) and Transplant Surgery at Singapore General Hospital (SGH). He served as the Director of the Laparoscopic programme and the Director of the Surgical Skills Training Program and the SingHealth Surgical Skills Centre.

He started his medical training at the National University of Singapore in 1996 and completed his training in General Surgery, HPB surgery and Liver Transplantation at SGH and National Cancer Centre, Singapore.

He also completed dual USA-fellowships in Advanced Laparoscopic HPB surgery and Liver Transplantation under Professor Daniel Cherqui at the New York Presbyterian Hospital-Weill Cornell Medical Center and a Complex Surgical Oncology clinical fellowship at Memorial Sloan Kettering Cancer Center in New York.

liver cancer surgeon - Dr Lee Ser Yee