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Cholangiocarcinoma is a rare cancer that arises from bile ducts cells within the liver. Cholangiocarcinoma can also arise in the bile ducts that are outside of the liver proper. Cholangiocarcinomas are usually first
discovered when a patients describes vague abdominal pain, weight loss, fever, and jaundice (yellowing of the skin). While abdominal imaging with x-ray can be useful in the diagnosis of cholangiocarcinoma, direct imaging of the bile ducts is often necessary. Endoscopic retrograde cholangiopancreatography (ERCP), an endoscopic procedure, is many times the test of choice to make the diagnosis. Although ERCP is an invasive procedure, its advantages include the ability to obtain biopsies and to place stents or perform other interventions to relieve biliary obstruction. Another effective test is endoscopic ultrasound, which can also be performed at the time of ERCP and may increase the accuracy of the biopsy and yield information on lymph node invasion and operability. As an alternative to ERCP, percutaneous transhepatic cholangiography (PTC) may be utilized. Magnetic resonance cholangiopancreatography (MRCP) is a non-invasive alternative to ERCP. 

Carcinoembryonal antigen, also known as CEA-a blood tumor marker for cancer, may be elevated in the blood of patients with this tumor. The blood level of CEA may falsely be elevated in other non-cancerous conditions of the liver where the bile ducts are inflamed or obstructed. In some parts of the world, liver fluke (Fasciola hepatica) infection is a predisposing risk for the development of cholangiocarcinoma.

Patients with primary sclerosing cholangitis, as disease of the bile ducts commonly seen in patients with ulcerative colitis, are also at increased risk for developing cholangiocarcinoma.

Small cholangiocarcinomas may be surgically resected or the patient may undergo liver transplantation.
Patients with cholangiocarcinomas that cannot be surgically resected may be treated with chemotherapy or radiation therapy.

Obesity and Fatty Liver Disease

Obesity, and all of its related complications, is more serious than most adults in America believe. More than one-third (34.9% or 78.6 million) of U.S. adults are obese. Obesity-related conditions include heart disease, stroke, type 2 diabetes, fatty liver disease, and certain types of cancer, are some of the leading causes of preventable death. We are seeing an increase in the number of young children and adolescents developing obesity, and all of the related complications.

The cost of obesity is staggering, with annual medical cost of obesity exceeding $147 billion in 2008 U.S. dollars. The medical costs for people who are obese were $1,429 higher than those of normal weight.

Dr. Galati and the Liver Specialists of Texas team are dedicated to evaluate, treat, and manage all aspects of obesity and non-alcoholic fatty liver disease (NAFLD and NASH), including the complication of cirrhosis and liver failure. Developing a customized plan of care for each patient they see is their objective.

Liver Transplant Resources

Dr. Galati has been involved in Liver Transplantation since 1989. As Medical Director for the Center for Liver Disease and Transplantation at Houston Methodist Hospital, Dr. Galati has cared for thousands of patients with advanced liver disease. In those with the most severe form of advanced liver disease and cirrhosis, liver transplantation is a life-saving surgery. For more information on liver transplantation, click here.

Indications for liver transplant include:

Online LIVER Second Opinion

  • 1

    From the comfort of your home, without the need to spend additional money on travel, lodging, and food, receive and expert second opinion from the expert physicians at Liver Specialists of Texas

  • 2

    There are five steps in the process of requesting a second opinion. We anticipate the steps will take you about 30-65 minutes to complete.

  • 3

    Have your medical records or those of your loved one on hand as you fill out the medical history questionnaire portion of the online process. The medical history questionnaire is detailed so having medical records to quickly reference will help make the process more efficient.

  • 4

    To start the process of an Online Liver Second Opinion, please fill out the initial contact form and fax back to our office. A representative from our office will call you for additional details.