Investigations and diagnosis
Haematology:
- anaemia
- raised leucocyte count
Biochemistry - cholestatic picture:
- raised serum bilirubin } levels may be
- raised alkaline phosphatase } very high or
- raised gamma glutamyl transpeptidase } may fluctuate
- normal alpha-feto-protein
Faeces:
- pale and fatty
- occult blood may be present
Diagnostic procedures:
- ultrasound - detects tumour mass, dilated ducts
- ERCP - shows abrupt or irregular obstruction to contrast, usually at hilum; brush cytology may be taken for histology
- percutaneous transhepatic cholangiogram (PTC) - defines extent of tumour
- CT / MRI - shows site of main bulk of tumour
- angiography and venography - defines nature and extent of vascular involvement
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