Symptoms of Gallbladder and Bile Duct Cancer

Patients with bile duct cancer most often become symptomatic when the cancer obstructs (blocks) the drainage of bile. Because bile cannot be excreted into the bowel, the bilirubin pigments accumulate in the blood, causing jaundice (yellowing of the skin and the whites of the eyes) in 90% of patients. The jaundice is usually associated with itching of the skin (also called "pruritus"). The body compensates partially and excretes some of this bilirubin via the urine, so patients may have dark (cola colored) urine. Because bile cannot reach the intestine, the patient's stools become white (clay colored).

Other symptoms result from inflammation secondary to tumor obstruction. Patients with gallbladder cancer may have pain in the right upper portion of the abdomen. This pain is a result of inflammation of the gallbladder (cholecystitis) due to blockage of the cystic duct. In fact, approximately 1% of patients who undergo cholecystectomy (surgical removal of the gallbladder) for suspected cholecystitis prove to have unsuspected gallbladder carcinoma. Distal bile duct tumors near the ampulla of Vater, the point at which the bile drains into the bowel, obstruct the pancreatic duct and lead to inflammation of the pancreas (pancreatitis).