One of the main treatments for bile duct cancer is surgery. Surgery may be done to:
- try to remove all of the cancer
- relieve symptoms.
The type of surgery you are offered will depend on:
- the size of the cancer
- whether it has begun to spread into nearby tissues
- your fitness and general health.
Surgery to remove all the cancer
Surgery may be able to cure the cancer for some people. But this is a major operation and is not always suitable. The surgery is complex and is carried out by a surgeon who is a specialist in bile duct cancer.
Your surgeon will look at the stage of the cancer to see if this type of operation is possible:
Cancer at a very early stage
If the cancer is at a very early stage the surgeon will remove only the bile ducts containing the cancer. They then join the remaining ducts in the liver to the small bowel. This allows the bile to flow again.
Intrahepatic bile duct cancer
If the cancer is in the bile ducts in the liver (intrahepatic bile duct cancer) the surgeon will remove the affected part of the liver and the bile ducts.
Perihilar bile duct cancer
If the cancer is where the left and right hepatic ducts meet just below the liver (perihilar bile duct cancer) the surgeon will remove the gall bladder and the part of the liver close to the bile ducts. Sometimes the surgeon will also remove part of the pancreas and part of the small bowel.
If the cancer is in bile ducts near the pancreas and the small bowel (distal bile duct cancer)
The surgeon will remove the bile ducts, gall bladder, part of the pancreas and part of the small bowel (duodenum). This is sometimes called a Whipple’s operation.
After your operation
You may need to stay in an intensive care ward for the first couple of days. You will then move to a general ward until you recover. Most people need to be in hospital for about 1 to 2 weeks after these types of operation.
If it was not possible to remove all the cancer during the operation, you may be offered extra treatment.The aim is to reduce the risk of the cancer coming back. This is called adjuvant treatment.
It may involve:
Doctors are not sure if adjuvant treatment is effective and these treatments can cause side effects. If your doctor offers you adjuvant treatment, they will talk to you about the possible benefits and disadvantages. This can help you decide whether to go ahead.
If the part of the small bowel called the duodenum is blocked, it can cause sickness (vomiting). This may be helped with an operation to bypass the blockage. The surgeon does this by connecting the stomach to the next section of small bowel (the jejunum).
If you have jaundice caused by a blocked bile duct, sometimes surgery can be used to bypass the blockage. But it is more common to have a thin tube called a stent put in to hold the bile duct open. This does not need an operation. We have more about this in our information about jaundice.