Types of surgery for bile duct cancer | Cancer Research UK
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Types of surgery for bile duct cancer

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This section is about surgery for bile duct cancer (cholangiocarcinoma). There is information about the different types of surgery you may have and what to expect before and after surgery.

 

A quick guide to what’s on this page

Types of surgery for bile duct cancer

The surgery you have depends on the stage of your cancer and its position in the bile ducts.

Surgery to remove bile duct cancer completely

Surgery to remove the whole cancer is a major operation. Only surgeons with specialist knowledge and experience should do this type of operation. To check whether it is possible for you to have surgery, your surgeon will look at the stage of your cancer and where it is in the bile ducts.

Your surgeon will remove your bile ducts. Depending on where the cancer is, your surgeon may also remove part of your liver, nearby lymph nodes, part of your small bowel, the gallbladder and part of your pancreas.

Surgery to relieve symptoms

Bile duct cancer may block the bile ducts and cause jaundice. Your doctor will put a small tube, called a stent, into your bile duct to relieve the blockage. They put the stent in during an endoscopy. Rarely, it is not possible to have a stent and you may have surgery instead to relieve jaundice.
 

CR PDF Icon You can view and print the quick guides for all the pages in the treating bile duct cancer section.

 

 

Types of operation for bile duct cancer

The surgery you have depends on the stage of your cancer and where it is growing in the bile ducts.

The tests you had to diagnose your cancer help your surgeon to decide which operation you need. Your surgeon may suggest

 

Removing bile duct cancer completely

Surgery to remove bile duct cancer is a major operation. Only surgeons with specialist knowledge and experience should do this type of operation. To check whether it is possible for you to have this surgery your surgeon will look at the stage of your cancer. This includes

  • The position of the cancer in the bile ducts
  • Whether the cancer has grown into tissues around the bile ducts
  • Whether there are cancer cells in the nearby lymph nodes
  • Whether the cancer has grown into any of the blood vessels nearby

The tests that you had to diagnose and stage your cancer will answer most of these questions. Scans can show the size and position of the cancer, and whether it has spread to other parts of the body. Sometimes it is not possible to tell if the cancer has spread into blood vessels and lymph nodes until you have the operation.

If you can have surgery, the type of operation depends on which bile ducts the cancer is growing in.

If the cancer is in the bile ducts in the liver (intrahepatic bile duct cancer) your doctor will remove part of your liver (hepatectomy). Usually the doctor needs to remove the whole lobe of the liver (lobectomy). The liver has two main lobes.

If your cancer is growing where the right and left hepatic ducts join together, just outside the liver, (perihilar bile duct cancer) your surgeon will remove

  • Part of your liver and the bile ducts
  • Your gallbladder
  • Lymph nodes close to the bile ducts

They may also remove part of your pancreas and small bowel. Then they will have to rejoin the remaining bile ducts to your bowel. And they may need to remove and rebuild parts of the major blood vessels which supply the liver.

If your cancer is in the bile ducts near the pancreas and small bowel (distal bile duct cancer) your surgeon will remove the bile ducts, part of your pancreas and part of your small bowel. They call this a pancreaticoduodenectomy (pank-ree-at-ic-oh dew-oh-den-ek-tom-ee) or Whipple operation.

There is detailed information about surgery to remove bile duct cancer in this section.

 

Surgery to relieve symptoms (palliative)

If the cancer is blocking your bile duct, you will have jaundice Your doctor will usually put a small tube (stent) into the bile duct to relieve the blockage. They put the stent in during an endoscopy.

Rarely, it is not possible to insert a stent.  You may then have surgery to relieve the jaundice and symptoms, such as itching. Doctors call this bypass surgery. Bypass surgery involves cutting the bile duct just above the tumour and rejoining it to the bowel. 

There is more information about stents to relieve jaundice in the advanced bile cancer section.

There is detailed information about surgery to relieve symptoms in this section.
 

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Updated: 20 January 2015