Best Bile Duct Cancer Surgery in Delhi, India

Bile duct cancer affects the bile ducts, which are tubes that transport bile from the liver to the small intestine. Surgery is the primary treatment option for bile duct cancer, and there are several different types of procedures that may be used, depending on the stage and location of the cancer.

Types of Bile Duct Cancer Procedures 

The specific procedures involved in bile duct cancer surgery depend on the location, extent of the tumour, and individual patient factors. Here are some common types of procedures used for bile duct cancer:

• Whipple procedure (Pancreaticoduodenectomy): This may involve removing the head of the pancreas, the first part of the small intestine, the gallbladder, the common bile duct, and sometimes, a part of the stomach. It is performed when the tumour is located in the upper section of the bile duct near the liver.
• Hepatectomy: This procedure involves the partial or complete removal of the liver. It may be performed when the tumour is located in the liver itself or when it involves a significant portion of the liver along with the bile duct.
• Extrahepatic Bile Duct Resection: This surgery involves the removal of a part of the bile duct, typically including the tumour and some surrounding healthy tissue. It may be performed when the tumour is located in the middle or lower part of the bile duct.
• Liver Transplantation: In some cases, when the cancer is limited to the bile duct and has not spread to other organs, a liver transplant may be considered. The procedure involves removing the diseased liver and transplanting a healthy liver from a donor.
• Biliary Bypass Surgery: If the tumour blocks the bile duct and causes bile to accumulate, a biliary bypass surgery may be performed. It involves creating a new pathway for bile to flow around the blocked area, relieving symptoms and improving quality of life.
• Endoscopic Stenting: In cases where the tumour cannot be removed surgically, an endoscopic stent may be placed to keep the bile duct open. This helps to alleviate symptoms caused by the blockage and allows the bile to flow freely.
• Palliative Surgery: In advanced cases of bile duct cancer where curative treatment is not possible, palliative surgery may be performed to relieve symptoms and improve quality of life. This may involve procedures such as tumour debulking or bypass surgeries to bypass the blocked area and improve bile flow.

Who is a Candidate for Bile Duct Cancer Surgery?

• Bile duct cancer surgery is usually recommended for individuals with cancer in the bile ducts and whose cancer is still confined to the bile ducts and hasn't spread to other parts of the body.
• The surgical removal of the cancerous tissue may be an option for those who are otherwise healthy enough to undergo the surgery and have enough healthy liver tissue remaining after the surgery. 
• A surgeon will consider a patient's overall health, the stage and location of the cancer, and other factors before deciding whether or not to perform the surgery.

Preparation for Bile Duct Cancer Surgery

• The doctor asks the patient about their personal and family medical history. They may also conduct a physical exam.
• Patients must undergo blood tests, imaging scans, and a biopsy to confirm the diagnosis and stage of cancer.
• Patients should inform their surgeons of current medications, medical conditions, and allergies.
• They should also avoid eating or drinking anything for several hours prior to the procedure.

How is the Bile Duct Cancer Procedure Performed?

The type of bile duct cancer surgery a patient undergoes will depend on the stage and location of the cancer. Some common procedures include:

• Resection of the bile duct: This involves removing a part of the bile duct that contains cancer and some surrounding healthy tissue.
• Whipple procedure: This is a major procedure that involves removing the head of the pancreas, a section of the small intestine, the gallbladder, and a portion of the bile duct.
• Liver transplant: The procedure may be recommended for those with advanced bile duct cancer that has spread to the liver.

Risks Factors Associated With Bile Duct Cancer Surgery 

Some risks of bile duct cancer surgery include:

• Bleeding: Surgery involves making incisions into the body, which can cause bleeding. In some cases, excessive bleeding may need blood transfusion and further surgery to stop the bleeding.
• Infection: Surgery also carries a risk of infection. Bile duct surgery involves working near the liver and other vital organs, which may increase the chances of infection.
• Damage to nearby organs: During surgery, there is a risk of accidentally damaging nearby organs like the liver, pancreas, or intestines.
• Blood clots: Blood clots can form during surgery and may travel to other parts of the body and cause complications.
• Delayed recovery: After surgery, it may take some time to fully recover and get back to normal activities. In certain cases, patients may need additional treatments like chemotherapy or radiation therapy.

Recovery after Bile Duct Cancer Surgery 

• After the procedure, patients may spend some days in the hospital for monitoring and recovery. 
• They may need to follow a special diet for several weeks to allow the bile ducts and digestive system to heal.
• Physical therapy is recommended to help improve mobility and strength.
• Most patients return to their normal activities in several weeks to several months, depending on the extent of the procedure and the patient's overall health.
• Patients must avoid lifting heavy objects, engaging in strenuous activities or operating heavy machinery.

Everyone's recovery from bile duct cancer surgery is unique and may take longer for some individuals. It is important to follow the doctor's instructions and attend follow-up appointments for a successful outcome.

Frequently Asked Questions

Is bile duct cancer operable?

The operability of bile duct cancer depends on the location, size of the tumour, cancer stage, and the general health of the patient. In some cases, bile duct cancer can be treated with surgery, while in others, a combination of surgery, chemotherapy, and radiation may be necessary.

Is bile duct cancer surgery painful?

The level of pain associated with bile duct surgery depends on the type of procedure, the patient's tolerance for pain, and the use of pain management techniques. In general, bile duct surgery is considered to be a major procedure and can be accompanied by pain and discomfort.

How serious is bile duct surgery?

Bile duct surgery is a serious procedure recommended when traditional treatment options have been exhausted or are not viable.

Can you live a normal life after surgery?

The recovery process following bile duct surgery can be long and challenging, but many people are able to return to normal life and live a good quality of life after the procedure. The extent of recovery and the ability to return to routine activities depends on the individual and the details of their surgery.

Can the bile duct be removed?

In some cases, the bile duct may need to be removed, either partially or completely, during bile duct cancer surgery. This can have a significant impact on the patient's digestive system and overall health, and close monitoring and medical management may be necessary to minimise any adverse effects.

How long can one be in the hospital after surgery?

The length of hospital stay after bile duct surgery depends on the type of procedure, the patient's health, and the extent of surgery. In general, patients can expect to be in the hospital for several days to a week, although some may need to stay longer for monitoring and recovery.

How many bile ducts are there?

There are typically two bile ducts in the human body: the common bile duct and the hepatic duct.

What is the cost of bile duct cancer surgery in India?

The cost of bile duct cancer surgery in India varies and depends on the type of procedure, the hospital, the doctor's expertise and the extent of the condition.

How long does it take to recover from bile duct surgery?

The recovery time after bile duct surgery depends on the type of procedure, overall health of the patient, and the extent of the surgery. Patients may take a few weeks to a few months recovering from bile duct surgery, with a full return to normal activities taking several months to a year or more.

Review 

Reviewed By Dr. Pankaj Kumar Pande, Associate Director, Surgical Oncology, Cancer Care / Oncology, Gastrointestinal & Hepatobiliary Oncology on 6 June 2024.