Diagnostic Tests and Workup
Cholangiocarcinoma can be diagnosed and followed up through lab tests and imaging studies. The most important lab tests include serum bilirubin levels, which are high at the expense of the conjugated or direct bilirubin. The alkaline phosphatase and gamma-glutamyltransferase levels are also higher than normal. In cholangiocarcinoma, patients may have normal or high liver enzyme levels, and the rest of the lab tests are still normal in the early stages of the disease.
Imaging studies are very useful in these cases and usually include ultrasonography and a CT scan. Some patients may require specialized studies such as endoscopic retrograde cholangiopancreatography.
Ultimately, the diagnosis relies on a biopsy to provide the final confirmation of cancer cells in the tumor.