Approach to Biliary Malignancies

Abstract Biliary malignancies arise from anywhere along the biliary tract and broadly encompass gallbladder cancer and cholangiocarcinoma. Surgical resection with curative intent remains the mainstay treatment for biliary tract malignancies, but despite advances in treatment and management over the years, prognosis remains poor. The majority of patients present with nonspecific clinical symptoms and are diagnosed at late-stage disease when surgical resection is no longer an option. In the minority of patients presenting with early-stage disease, it is particularly important to determine accurate radiological staging and take a multidisciplinary approach to determine patients suitable for curative surgical resection. A range of imaging modalities is often used in combination, each providing complementary information to characterize and stage disease. Gallbladder cancer and cholangiocarcinoma are distinct entities and the approach to each of these will be discussed separately.