Bile Duct Cancer Surgery Cost in Pune, India

Bile Duct Cancer Surgery: Types, Purpose, Procedure & Recovery

Bile Duct Cancer, also called Cholangiocarcinoma, is a rare but aggressive form of cancer that affects the cells of bile duct. It affects around 0.5-1.2 in 100.000 people globally.

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Treatment Overview

Bile Duct Cancer, also called Cholangiocarcinoma, is a rare but aggressive form of cancer that affects the cells of bile duct. It affects around 0.5-1.2 in 100.000 people globally. It is more likely to occur in men than women, probably in their 70s. Its incidence and fatalities are rising globally. Research indicates that the risk for acquiring cholangiocarcinoma may be higher in biological relatives of an individual with the cancer than in anyone else. However, the majority of bile duct cancer patients do not have such cancer history in their family.

By the time doctors diagnose it, it has already spread beyond the bile ducts. At this stage of cancer spread, the chances of recovery are very less and it becomes challenging to achieve treatment success and cancer remission. Because of this, it's considered an aggressive and life threatening cancer form.

For bile duct cancers, surgery is one of the viable treatments. Palliative surgery is performed to treat complications, while curative surgery is performed for early-stage cancers. It's a major surgery that requires extensive preparation and a long recovery time.

Researchers are constantly working to develop novel therapeutic approaches to mitigate the progression of cancer and enhance the prognosis related to cholangiocarcinoma. The clinical trials are still ongoing to enhance such cancer treatment outcomes and enhance the survival rates.

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Bile Duct Cancer Surgery Overview

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What is Bile Duct Cancer Surgery

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What is Bile Duct Cancer Surgery?

Bile duct cells undergo genetic alterations to form bile duct cancer or cholangiocarcinoma. The causes of such genetic changes in the cells have not been established. This results in uncontrolled proliferation of bile duct cells and formation of mass of cells (tumor). This tumor can potentially infiltrate and kill healthy cells.

Curative surgeries are performed to treat early stage tumors and palliative surgeries are performed to relieve symptoms in patients at any cancer stage. For bile duct cancer, there are various surgical procedures developed to either treat the disease or lessen its symptoms. Your general health, the type and stage of the cancer, and the type of surgery, all determine the success of the treatment.

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Purpose of Bile Duct Cancer Surgery

The goal of surgery for bile duct cancer is to remove the tumor along with some healthy surrounding tissue. It provides excellent chances for bile duct cancer patients to combat the cancer and recover. However, not every bile duct cancer patient is a candidate for this surgery. Less than 30% of patients with bile duct cancer (nearly three out of ten) are eligible for surgery for cancer removal. This is due to the fact that the majority of cancer diagnoses occur after the disease has already spread to other body parts. This is called advanced bile duct cancer. Generally, palliative care, radiotherapy, and/or chemotherapy is given to patients in advanced stages.

Liver surgeon may advise treatment to reduce the likelihood of the cancer returning after surgery. Such treatment is called Adjuvant therapy. Chemotherapy using capecitabine is typically administered for six months following surgery.

Purpose of Bile Duct Cancer Surgery

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Types of Bile Duct Cancer Surgery

For bile duct cancer, there are numerous types of palliative and curative surgical options. Following are the surgical approaches:

Palliative surgeries

This surgery is done to alleviate cancer symptoms such as bile duct blockages. Following are the various type:

  • Biliary bypass: When a tumor obstructs the bile ducts, a surgical procedure known as a biliary bypass is used to open up a new channel for bile to flow (bile duct obstruction). This relieves symptoms like pain and jaundice by allowing bile to pass through the obstruction and enter the small intestine.
  • Biliary stent or biliary catheter: When biliary bypass is not an option, catheter or stent implantation may be used instead. Rather, to help keep the duct open, a surgeon will insert a tiny tube into it. A stent is a tube made of plastic or metal that passes through the duct blockage. A catheter is a flexible tube that is placed in the drainage bag outside of your body and has one end attached to the bile duct.
Curative surgery

This surgery is done to remove the cancerous tissue along with some surrounding healthy cells. Following are the various type:

  • Bile duct resection: It is done to remove the cancer involving the bile ducts present outside the liver. The damaged bile duct will be removed by a surgeon, who will then create a new one by joining the remaining bile duct to the intestine.
  • Partial hepatectomy: A portion of the liver and the damaged bile ducts are removed during this procedure. It is carried out on the liver's internal bile ducts.
  • Hepatic lobectomy: When compared to a partial hepatectomy, this procedure is more complex. It opted to treat the cancers that have metastasized within the liver. It entails removing your liver's entire lobe, left or right.
  • Whipple procedure: This approach involves the removal of the pancreatic head, the first segment of the small intestine, a portion of the bile duct, and the gallbladder by skilled surgeons. To maintain digestive function, surgeons join the small intestine to the pancreas and remaining bile duct.
  • Liver Transplant: The doctor might advise having a liver transplant and completely removing the liver and bile ducts if the cancer has spread too far inside the liver or if it is hard to access.
Types of Bile Duct Cancer Surgery

Pre-evaluation of Bile Duct Cancer Surgery

The pre-evaluation procedure for bile duct cancer surgery may involve thorough evaluation of symptoms, medical history recording, and physical examination. Findings from these examinations, may call for the following investigations for reaching to a final diagnosis and chart-out the right treatment plan:

  • Blood tests for alpha-fetoprotein (AFP)
  • Computed tomography (CT) scan for liver tumor size and location
  • Magnetic resonance imaging (MRI) for better image of tumor
  • Angiogram for the examination of your liver’s blood vessels
  • Biopsy to confirm a liver cancer diagnosis
  • Endoscopic retrograde cholangiopancreatography (ERCP) to examine your bile ducts
  • Percutaneous transhepatic cholangiography (PTC) for people who can’t have an ERCP
Pre-evaluation of Bile Duct Cancer Surgery

Procedure of Bile Duct Cancer Surgery

Throughout the process you will remain unconscious as general anesthesia will be administered to you. The medical staff will place a breathing tube through your mouth and into your windpipe once you're completely asleep to assist with breathing. In order to improve blood flow, they will also place compression socks on your lower legs.

The length of the surgery can range from two to five hours, depending on how complicated the procedure is. A surgeon will make incisions during this period to extract damaged organ tissue or to re-establish bile flow.

Procedure of Bile Duct Cancer Surgery

Recovery After Bile Duct Cancer Surgery

Complications of Bile Duct Cancer Surgery

Following are the complications associated with this surgery:

  • Bleeding
  • Abnormal blood clots formations
  • Infections
  • Complications from anesthesia
  • Pneumonia
  • Pain
  • Bile leakage into the abdomen
  • Liver failure
  • Eating and nutrition problems
Complications of Bile Duct Cancer Surgery

Conclusion

Receiving a timely diagnosis for cholangiocarcinoma, also known as bile duct cancer, can be challenging. Early detection of this kind of cancer, when it is curable through surgery, can be challenging. Cancer diagnoses are still unique from one another. The advantages and disadvantages of different bile duct cancer surgery depends on the type and severity of the cancer.

Frequently Asked Questions

Q1: How successful are bile duct cancer surgeries?

A: The 3-, 5- and 10-year survival rate of a bile duct cancer surgery is 55.3%, 48.3% and 33.7%, respectively.

Q2: Is there a cure for bile duct cancer?

A: Bile duct cancer is curable only if the cancerous cells have not spread. In such a situation, the bile duct may be removed partially or completely. Merely a minor fraction of cases of bile duct cancer are identified at an early stage that makes surgery appropriate.

Q3: In what way is bile duct surgery complex?

A: A bile duct cancer removal procedure is a major surgical procedure. Even following surgery, bile duct cancer often returns. Furthermore, issues could arise following this procedure.

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