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Investigations and diagnosis

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

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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