• Anus
  • Bladder
  • Liver
  • Pancreas
  • Small Bowel Malignancies
  • Stomach

Diagnostic and Staging Work-Up

  • The diagnosis may be made by suspicious findings on work-up for suspected gallstone disease or unexplained abdominal pain
  • Diagnosis is often an incidental finding of pathology post-cholecystectomy.
  • If there appears to be an isolated lesion, refer to a hepatobiliary surgeon who will determine if the disease is resectable or unresectable and arrange for the appropriate investigations
  • Tissue diagnosis can be difficult to obtain 
  • Triphasic CT scan of the abdomen is recommended to assess extent of local involvement 
  • Contrast-enhanced MRI may also provide information on diagnosis and extent of disease
  • CT scan of the chest and pelvis are recommended to exclude distant metastases
  • The presence of a bile duct stricture and/or jaundice is an ominous feature
  • PET scan is not routinely recommended for staging purposes
  • Laparoscopy may be considered for staging
  • Recommend baseline tumour markers at diagnosis: CEA, CA 19-9