Editing Cholangiocarcinoma (section)

== '''Risk factors''' ==

* Anything that causes biliary inflammation, and compensatory cellular proliferation

=== Modifiable ===

** Alcohol abuse
** Obesity (NASH/NAFLD)
** Diabetes
** Carcinogens
*** Thorotrast
*** COCP
*** Asbestos
*** Smoking

=== Non-modifiable ===

** Sclerosing cholangitis (8-20% lifetime risk; 1.5% per year)

*** Autoimmune multifocal strictures of the intra-hepatic and extra-hepatic biliary trees
*** Most common risk factor for cholangiocarcinoma in the West
*** Associated with multifocal cholangiocarcinoma

** Choledochal cysts (3-28% lifetime risk)
** Cirrhosis
** Biliary parasites (liver flukes - Clonorchis sinensis and Opisthorchis viverrini)

*** Cause chronic biliary inflammation, with obstructions and strictures

** Hepatolithiasis
** Recurrent pyogenic cholangitis

*** Primary bile duct stone formation with infections

** Infections of biliary tree (Salmonella, HCV, HBV)
** Usually seen 60-70yo