Karel Kroupa
In the United States, an estimated 20 000 new cases of liver and biliary tract cancer are diagnosed annually. Biliary tract cancer is the second most common primary hepatobiliary cancer, after hepatocellular cancer. Approximately 7 500 new cases of biliary tract cancer are diagnosed per year; about 5 000 of these are gallbladder cancer, and between 2 000 and 3 000 are bile-duct cancers. Biliary tract cancers have been divided into cancers of the gallbladder, intrahepatic, perihilar, and distal extrahepatic tumors of the bile ducts. Cholangiocarcinoma, both intrahepatic and extrahepatic, is a well-known complication of primary sclerosing cholangitis. At present, only surgical excision of all detectable tumor is associated with improvement in five-year survival.