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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

SOURCE: Diagnostic and Staging Work-Up ( )
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