Billiary

** About the bile duct –
Bile helps to aid digestion by breaking down the fats in the foods we eat. It is made in the liver and stored in the gall bladder, and carried around our bodies by the bile ducts, which connect the liver to the gall bladder. Together, the bile ducts and the gall bladder are known as the biliary system.
** Cancer of the biliary duct
Bile Duct cancer is not common, occurring in an estimated 1 in every 100,000 people. It accounts for 10-15% of all primary liver cancer, and can affect both men and women. Although it is rare, it is an aggressive cancer and in most cases it does not present with symptoms until it is in its later stages.
There are two main types of bile duct cancer; intrahepatic bile duct cancer which originates from the part of the bile duct inside the liver, or extrahepatic bile duct cancer which starts in the bile duct outside of the liver.
Bile duct cancer is only curable if the cancerous cells have not spread, in which case some of the bile duct will be removed. For those in the advanced stages of the condition chemotherapy and in some cases, surgery is used to enhance the patient’s quality of life.
** Treatment of biliary cancer –
Treatment will be decided depending on the position and size of the cancer. Deciding factors will also be based on if the cancer has spread beyond the bile duct.
In certain cases, the aim of treatment is to relieve symptoms rather than a cure.
Surgery
Surgery is the main form of treatment in the attempt to cure bile duct cancer. The decision regarding whether surgery is possible and the type of operation that may be undertaken as mentioned previously, depends on the size of the cancer and whether it has spread into nearby tissues.
Removal of the bile ducts
If the cancer is at a very early stage only the bile ducts containing the cancer are removed. The remaining ducts in the liver are then joined to the small bowel, allowing the bile to flow again.
Partial liver resection
If it is found that the cancer has spread into the liver, the affected part of the liver and the bile ducts are removed.
Whipple’s procedure
If the cancer is larger and has spread into nearby structures, then the bile ducts, part of the stomach, part of the small bowel (duodenum), the pancreas, gall bladder and the surrounding lymph nodes are all removed. Following this type of surgery it is likely patients will stay in intensive care for the first few days following the surgery.
Surgery to relieve blockage (obstruction)
The tumour may be difficult to remove, if this is the case an operation to help relieve the blockage may be undertaken. Through having this surgery any jaundice will subside. During surgery the Consultant will create a bypass of the blocked part of the bile duct, the bile can then flow from the liver into the intestine.
Stent insertion
A stent is a tube inserted into the bile duct to hold it open and allow bile to drain away.
A stent may be put in using an ERCP or occasionally a PTC procedure (see below).
The ERCP method
Your Consultant will be able to see the narrowing in the bile duct through looking at x-rays. This narrowing is then stretched using dilators and the stent is inserted through the endsoscope which allows the bile to drain.
The PTC method
This method uses a temporary wire which is passed to the blocked area and the stent is guided along the wire. Occasionally a drainage tube (catheter) is left in the bile duct. One end of the catheter is in the bile duct and the other stays outside the body connected to a bag, which collects the bile.
Through doing this, the catheter helps with the insertion of the stent or, sometimes, to allow x-rays to be taken to check the position of the stent after it has been put in place.
There are occasions when a combination of ERCP and PTC may be used.
Chemotherapy .
Chemotherapy may occasionally be used after surgery if all the cancer could not be removed by the operation. The aim of chemotherapy treatment is to try to shrink or slow down the growth of the cancer and to relieve symptoms. This form of treatment may also be used if an operation isn’t possible or the cancer has recurred after initial treatment.
For more information on chemotherapy, please click here. (This will link off to info we have solely about chemo)

About the bile duct

Bile helps to aid digestion by breaking down the fats in the foods we eat. It is made in the liver and stored in the gall bladder, and carried around our bodies by the bile ducts, which connect the liver to the gall bladder. Together, the bile ducts and the gall bladder are known as the biliary system. Billiary System

Cancer of the biliary duct

Bile Duct cancer is not common, occurring in an estimated 1 in every 100,000 people. It accounts for 10-15% of all primary liver cancer, and can affect both men and women. Although it is rare, it is an aggressive cancer and in most cases it does not present with symptoms until it is in its later stages.

There are two main types of bile duct cancer; intrahepatic bile duct cancer which originates from the part of the bile duct inside the liver, or extrahepatic bile duct cancer which starts in the bile duct outside of the liver.

Bile duct cancer is only curable if the cancerous cells have not spread, in which case some of the bile duct will be removed. For those in the advanced stages of the condition chemotherapy and in some cases, surgery is used to enhance the patient’s quality of life.

Treatment of biliary cancer

Treatment will be decided depending on the position and size of the cancer. Deciding factors will also be based on if the cancer has spread beyond the bile duct.

In certain cases, the aim of treatment is to relieve symptoms rather than a cure.

Surgery

Surgery is the main form of treatment in the attempt to cure bile duct cancer. The decision regarding whether surgery is possible and the type of operation that may be undertaken as mentioned previously, depends on the size of the cancer and whether it has spread into nearby tissues.

Removal of the bile ducts

If the cancer is at a very early stage only the bile ducts containing the cancer are removed. The remaining ducts in the liver are then joined to the small bowel, allowing the bile to flow again.

Partial liver resection

If it is found that the cancer has spread into the liver, the affected part of the liver and the bile ducts are removed.

Whipple’s procedure

If the cancer is larger and has spread into nearby structures, then the bile ducts, part of the stomach, part of the small bowel (duodenum), the pancreas, gall bladder and the surrounding lymph nodes are all removed. Following this type of surgery it is likely patients will stay in intensive care for the first few days following the surgery.

Surgery to relieve blockage (obstruction)

The tumour may be difficult to remove, if this is the case an operation to help relieve the blockage may be undertaken. Through having this surgery any jaundice will subside. During surgery the Consultant will create a bypass of the blocked part of the bile duct, the bile can then flow from the liver into the intestine.

Stent insertion

A stent is a tube inserted into the bile duct to hold it open and allow bile to drain away.

A stent may be put in using an ERCP or occasionally a PTC procedure (see below).

The ERCP method

Your Consultant will be able to see the narrowing in the bile duct through looking at x-rays. This narrowing is then stretched using dilators and the stent is inserted through the endsoscope which allows the bile to drain.

The PTC method

This method uses a temporary wire which is passed to the blocked area and the stent is guided along the wire. Occasionally a drainage tube (catheter) is left in the bile duct. One end of the catheter is in the bile duct and the other stays outside the body connected to a bag, which collects the bile.

Through doing this, the catheter helps with the insertion of the stent or, sometimes, to allow x-rays to be taken to check the position of the stent after it has been put in place.

There are occasions when a combination of ERCP and PTC may be used.

Chemotherapy

Chemotherapy may occasionally be used after surgery if all the cancer could not be removed by the operation. The aim of chemotherapy treatment is to try to shrink or slow down the growth of the cancer and to relieve symptoms. This form of treatment may also be used if an operation isn’t possible or the cancer has recurred after initial treatment.

For more information on chemotherapy, please click here. (This will link off to info we have solely about chemo)