What to Know About Surgery for Bile Duct Cancer

The type of surgery you have depends on the exact location of the tumor and how far it has spread.

Surgery is commonly used to treat bile duct cancer. It is currently the only treatment that can sometimes cure bile duct cancer in people whose cancer has not spread. The type of surgery your doctor chooses depends on the exact location of the cancer and how far it has spread. Here are some surgical options for bile duct cancer.

• Removal of the bile duct. If you have a small tumor that is confined to the bile duct outside but near the liver, called perihilar bile duct cancer, the surgeon may remove the entire bile duct. The surgeon will make a new connection to your small intestine, allowing the bile to flow again. If the cancer has spread to nearby tissues, usually the liver, the surgeon may need to remove part of that tissue as well. Your surgeon may also remove nearby lymph nodes and examine them for signs of cancer.

• Partial hepatectomy, also called liver resection. For this operation, the surgeon removes the part of your liver where the intrahepatic bile duct cancer is found. This may also be done if cancer is in the hepatic duct very close to the liver. A large or small part of your liver may be removed. The surgeon may also remove some surrounding normal tissue to be sure that all the cancer taken out.

• Whipple procedure, also called pancreaticoduodenectomy. If the bile duct cancer is very close to your pancreas, you may need this surgery. For this procedure, the surgeon takes out your bile duct and your gallbladder, along with part of your pancreas, part of your stomach, and the first part of your small intestine. 

• Surgical biliary bypass. If the surgeon cannot completely remove the bile duct cancer, he or she may do a bypass to lessen symptoms caused by the cancer. For example, if the cancer is blocking the bile ducts and bile builds up behind the blockage, surgery can help relieve the obstruction. During this operation, the doctor will connect your bile duct to a piece of your small intestine. This will create a new pathway around the blockage to allow the bile to flow to your intestine for normal digestion of fats. This surgery does not cure the cancer, but it can relieve jaundice and other symptoms. It may precede other types of treatment.