Malignant Biliary Diseases

Biliary tract and pancreatic carcinomas are aggressive malignancies and present a major challenge in their diagnosis and treatment. Surgical resection remains the only potentially curative treatment and the prognosis for patients with unresectable or metastatic disease is poor. This chapter discusses primary carcinoma of the gallbladder, carcinoma of the intrahepatic and extrahepatic bile ducts (cholangiocarcinoma) and periampullary carcinoma. Careful patient selection for appropriate treatment options is important in the management of patients with bile duct and pancreatic carcinoma. The preoperative diagnosis and staging, current treatment options, outcomes of surgery and adjuvant treatments, and surgical and non-surgical palliation are discussed in detail.