- internistic
Prof. Dr. med. Thomas Seufferlein
Ärztlicher Direktor der Klinik für Innere Medizin I (Speiseröhre, Magen, Darm, Leber und Niere sowie Stoffwechselerkrankungen) und Sprecher des Darmzentrums
Dr. med. Thomas J. Ettrich
Oberarzt, Leiter Schwerpunkt GI-Onkologie, Leiter des klinischen Studienzentrums GI-Onkologie
Schwerpunkte
Gastrointestinale Onkologie, Klinische Studien
- Surgical
- radiooncological
Description of the disease
Within the tumours of the biliary system, we differentiate between tumours of the gallbladder and the bile ducts. Tumours of the bile ducts can also be divided into tumours of the bile ducts inside and outside the liver. Malignant tumours of the opening of the bile duct into the duodenum (papillary tumours) are usually classified as pancreatic tumours due to their close proximity, but formally belong to the group of bile duct tumours.
Frequency and age of onset
Malignant tumours of the biliary tract and gallbladder (biliary system) are generally rare diseases with an annual incidence of around 5 cases per 100,000 inhabitants.
Causes and risk factors
While malignant tumours of the biliary tract occur more frequently in men than in women, gallbladder carcinomas are more common in women (ratio 2:1), which can primarily be explained by the more frequent occurrence of gallbladder stones in women. Gallstones are found in almost all patients (74-92%) with gallbladder carcinoma, but only very few patients with gallbladder stones develop gallbladder carcinoma in the course of their lives. However, in the presence of gallbladder stones with typical symptoms (symptomatic gallstones), the risk of a carcinoma forming appears to be increased; patients with symptomatic gallstones are usually operated on for other reasons.
In the course of gallbladder operations, gallbladder carcinoma is diagnosed in approx. 1% of cases during tissue work-up.
Other diseases that are considered a risk factor for gallbladder carcinomas are chronic inflammation of the gallbladder. Malignant tumours can also develop from polyps in the gallbladder, although this primarily applies to polyps that are observed to grow larger than 10 mm.
The risk factors for carcinomas of the bile ducts are known to a lesser extent. In addition to inflammatory diseases such as "primary sclerosing cholangitis (PSC)", a moderately increased risk of disease is assumed in chronic smokers.
Signs of illness
There are no characteristic early symptoms. Yellowing of the skin and eyes (jaundice) often occurs during the course of the disease, which is caused by a tumour-related lack of drainage of bile into the intestine. While this jaundice in gallbladder carcinoma usually indicates an advanced stage, smaller carcinomas of the bile ducts can also lead to an obstruction and thus to the development of this yellow colouration. Many patients with gallbladder carcinoma also report pressing pain in the right upper abdomen, although this does not specifically indicate malignant tumour disease of the gallbladder.
Weitere Informationen: www.krebsinformationsdienst.de/gallenblasenkrebs-und-gallengangskrebs