Primary bile duct cancers are rare and generally aggressive entities. Historically, this disease was managed exclusively with surgical therapy with few long-term survivors. However, with improvements in chemotherapeutics, targeted therapy, interventional radiology techniques and development of alternative surgical approaches, treatment has moved to the utilization of a multidisciplinary care team employing multimodality treatments which has finally led to improvement in outcomes. In this book, Chapter One examines symptoms and the current state of medical and surgical management of bile duct cancer, while Chapter Two discusses the clinical aspects of care of extrahepatic biliary cancers with an emphasis on diagnosis and management. Chapter Three assesses the risk of bile duct cancer among beneficiaries of The Health Insurance Society of Printing Industry (HISPI) using diagnosis-procedure-combination (DPC) data in comparison with general population. Chapter Four concludes with a summary of results for chemotherapy and targeted therapies.