Problems after bile duct cancer surgery
Most operations to remove bile duct cancer are major operations. You usually have them in specialist centres. Like all operations there is a risk of problems or complications.
A complication is anything that happens after surgery that makes your recovery more difficult. Chest infections and blood clots are possible complications after any surgery.
Before offering surgery, your doctor makes sure the benefits of having the operation outweighs the risks. Discussing the risks with your surgeon will help you decide whether to have surgery or not.
Some complications can be serious. But they are becoming less common as surgeons get better at deciding who is likely to make a good recovery. When the aim is to try to cure your cancer, you and your doctor may feel it is worth taking some of these risks.
Leakage of bile
A leak can happen in the area where the bile ducts are stitched back together or the cut surface of the liver. This can cause a collection of bile.
Your doctor usually leaves a drainage tube until the bile leak stops.
An abnormal opening (fistula)
The word fistula means opening. A fistula may develop from the bile duct or pancreas after surgery. This means bile or digestive juices can leak into surrounding tissues. This can cause pain and infection.
If this happens, your doctor puts in a tube to drain it. You also have medicines to control swelling (inflammation). The tube stays in until the fistula dries up. The fistula then heals on its own. Sometimes the surgeon has to operate again to repair the leak.
Liver failure
Some people develop liver failure after surgery. The risk is higher if you have had liver problems before.
Before you have surgery, you have tests to check how well your liver is working and to check for other liver conditions such as cirrhosis.
Infection
There is a risk of infection after any operation. An infection can develop if there is a build up of fluid or blood after your surgery. The wound area may also become red and sore.
Your nurse will give you antibiotics through your drip if you develop an infection. Your doctor will drain abscesses or any fluid that has collected internally. They usually do this by using an x-ray or ultrasound to help guide a needle or tube into place.
Chest infection
A chest infection is a common complication of many operations. It happens because you are not moving around or breathing deeply enough after your surgery. What you would normally cough up stays in your lungs and becomes a focus for infection. You can help to prevent this by doing your deep breathing exercises.
Your 
and nurses will get you up as soon as possible to help you get moving.
Below is a short video showing breathing and circulation exercises after surgery.
Breathing and circulation exercises after surgery
These exercises help prevent you developing a chest infection or blood clots in your legs after surgery. These problems are more likely when you are not moving around as you would normally.
You can do these breathing exercises while sitting up in a chair or in a bed or whilst lying down.
Relax your shoulders and upper chest.
Take a slow, deep, comfortable breath in and hold for a couple of seconds, then slowly breathe out.
Repeat this 3 times.
You can start these breathing exercises as soon as you come round from your anaesthetic.
You should try to do them every hour when awake until you are fully mobile.
If you need to cough, support your wound with your arms, a pillow or a rolled up towel.
If you are struggling to clear any phlegm, try a huff. This is where you breathe out in a short, sharp manner as if you were trying to steam up a mirror.
You should move about as soon as possible after your operation. But while you are not as mobile, try to keep your legs moving to encourage better circulation.
You can do these exercises in a bed or in a chair.
One foot at a time, point your toes away from you then pull your toes towards your chin.
Try to do 10 of these on both feet at least 2-3 times an hour.
The next exercise is circling your ankles. One at a time circle your ankles, clockwise and then anticlockwise. Repeat this 10 times with each ankle 2-3 times an hour.
Bleeding
You may have bleeding straight after your operation. This could be because a blood vessel tie is leaking or because your blood is not clotting properly. Bleeding in the few days following surgery can happen because of an infection or a fistula forming.
The treatment you need depends on what is causing the bleeding. Your doctor and nurses will check for signs of bleeding after surgery. You may need a blood transfusion after your operation.
Heart problems
You have heart tests before your surgery to make sure your heart is able to cope with the operation. But bile duct operations can increase the strain on your heart. Some people develop heart problems after surgery that they did not have before.
Your doctor and nurses will check for signs of heart problems after your operation.
Blood clots
Blood clots (deep vein thrombosis, DVT) are a possible complication of having surgery because you might not move about as much as usual. Clots can block the normal flow of blood through the body. Let your doctor or nurse know if you have an area in your leg that is swollen, hot, red or sore.
There is a risk that a blood clot can become loose and travel through the bloodstream to the lungs, causing a blockage there (a pulmonary embolism). Symptoms include:
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shortness of breath
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chest pain
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coughing up blood
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feeling dizzy or lightheaded
If you have any symptoms of a blood clot when you are at home, see your GP or go to your nearest accident and emergency department (A&E).
To try to prevent blood clots you wear compression stockings after surgery. You also have daily injections for several weeks to thin your blood, and your nurses will encourage you to get up as soon as possible or do regular leg exercises.
