Editing Cholangiocarcinoma (section)

==Signs and symptoms==
[[File:Jaundice of the sclerotic.JPG|thumb|Yellowing of the skin ([[jaundice]]) and eyes ([[scleral icterus]]).]]

The most common physical indications of cholangiocarcinoma are abnormal [[liver function tests]], [[jaundice]] (yellowing of the eyes and skin occurring when bile ducts are blocked by tumor), [[abdominal pain]] (30–50%), [[pruritis|generalized itching]] (66%), [[weight loss]] (30–50%), fever (up to 20%), and changes in the color of [[human feces|stool]] or [[urine]].<ref>{{cite journal | vauthors = Nagorney DM, Donohue JH, Farnell MB, Schleck CD, Ilstrup DM | author-link5 = Duane Ilstrup | title = Outcomes after curative resections of cholangiocarcinoma | journal = Archives of Surgery | volume = 128 | issue = 8 | pages = 871–7; discussion 877–9 | date = August 1993 | pmid = 8393652 | doi = 10.1001/archsurg.1993.01420200045008 }}</ref> To some extent, the symptoms depend upon the location of the tumor: people with cholangiocarcinoma in the extrahepatic bile ducts (outside the liver) are more likely to have jaundice, while those with tumors of the bile ducts within the liver more often have pain without jaundice.<ref name="nakeeb">{{cite journal | vauthors = Nakeeb A, Pitt HA, Sohn TA, Coleman J, Abrams RA, Piantadosi S, Hruban RH, Lillemoe KD, Yeo CJ, Cameron JL | display-authors = 6 | title = Cholangiocarcinoma. A spectrum of intrahepatic, perihilar, and distal tumors | journal = Annals of Surgery | volume = 224 | issue = 4 | pages = 463–73; discussion 473–5 | date = October 1996 | pmid = 8857851 | pmc = 1235406 | doi = 10.1097/00000658-199610000-00005 }}</ref>

[[Liver function tests|Blood tests of liver function]] in people with cholangiocarcinoma often reveal a so-called "obstructive picture", with elevated [[bilirubin]], [[alkaline phosphatase]], and [[gamma glutamyl transferase]] levels, and relatively normal [[transaminase]] levels. Such laboratory findings suggest obstruction of the bile ducts, rather than [[inflammation]] or infection of the liver [[parenchyma]], as the primary cause of the jaundice.<ref name="feldman2">{{cite book|editor1=Mark Feldman|editor2=Lawrence S. Friedman|editor3=Lawrence J. Brandt|title=Sleisenger and Fordtran's Gastrointestinal and Liver Disease|edition=8th|date=21 July 2006|publisher=Saunders|isbn=978-1-4160-0245-1|pages=[https://archive.org/details/sleisengerfordtr0000unse_j1o5/page/1493 1493–6]|url-access=registration|url=https://archive.org/details/sleisengerfordtr0000unse_j1o5/page/1493}}</ref>