The most important test in checking for a bile duct cancer is an ultrasound examination. This very simple investigation can be done as an out-patient and simply involves gently rubbing an instrument a bit like a microphone over upper part of the belly and the lower part of the chest. It is quite painless and only takes a few minutes. The ultrasound produces uses sound waves to produce a picture of the underlying organs.
If the ultrasound scan clearly shows that the cancer has spread to other nearby organs and is too advanced for an operation then there may be little need for further tests.
If the ultrasound suggests that an operation might be possible then the next step would be to do a CT scan of the area. This can give more accurate information than an ordinary ultrasound scan about whether or not the cancer has spread to nearby lymph nodes, and organs, such as the liver. This will help the specialist decide whether or not to recommend surgery. MRI scans have also been used and can give similar information to a CT scan.
Other tests which may give helpful information about the extent of the cancer include:
- endoscopic ultrasound: this uses a special endoscope, a thin flexible telescope, which is passed through the mouth and gullet, into the stomach and then into the small intestine near to the gallbladder. It has a special ultrasound probe and can take ultrasound pictures from inside the body. Before the test a sedative is given to help the person relax.
- endoscopic retrograde cholangiopancreatography (ERCP): this again uses an endoscope, but this time the instrument is used to put dye into the bile ducts so they show up on x-rays. Before this a sedative is given to help the person relax.
Some blood tests may also be helpful, in particular tests checking for the presence or absence of jaundice.