Bile Duct Cancer Surgery

When it comes to bile duct cancer, the most effective treatment option is surgery, since successful removal of the cancer leads to improved outcomes. There are a variety of innovative surgical options available. Determining the best surgical treatment depends on where in the bile ducts the tumor is located.

• Bile Duct Excision: If the tumor is small and is located only in the bile duct, the entire bile duct may be removed, and bypassed with the intestines. This procedure is often referred to as a Bile Duct Excision and Roux-en-Y Hepaticojejonostomy. In addition, lymph nodes are removed and viewed under a microscope to determine if they contain cancer.
• Stent Placement: If the tumor is blocking the bile duct, a stent (a thin tube) may be placed in the duct to drain bile that has built up in the area. The stent may drain to the outside of the body, or it may drain into the small intestine. The stent may be placed during surgery, or during a cholangiography procedure.
• Bile Duct Excision with Liver Resection: If the tumor is located in the bile ducts within the liver (or very near the liver), a liver resection is generally recommended along with removal of the involved bile ducts. The type of liver resection required is determined by the extent of the tumor. Possibilities include: lobectomy, central resection, and trisegmentectomy.
• Whipple Procedure: For tumors affecting the bottom half of the bile duct, which is associated with the pancreas, the cancer may be removed with a Whipple Operation. This procedure involves resection (removal) of the head of the pancreas, a portion of the bile duct, the gallbladder and the duodenum. Occasionally, a portion of the stomach may also be removed.