Surgery is the preferred treatment for bile duct cancer and offers the best chance for a cure. The location and sensitivity of the bile ducts make surgery challenging. These procedures require a high level of expertise. For tumors that have not spread, the most effective approach is using a traditional open technique. Minimally invasive surgery is generally not used for bile duct surgery. 

Partial Hepatectomy

This procedure is often used to treat large bile duct tumors inside the liver (intrahepatic tumors). It involves removing a piece of normal liver tissue, an entire lobe, or a larger part of the liver surrounding the cancer. The remaining section of the liver takes over all of the organ’s functions. Sometimes the liver grows back to its normal size within a few weeks. Before a partial hepatectomy, doctors may use a technique called portal vein embolization to redirect the blood supply to the healthy portion of the liver. This stimulates cell growth in the healthy part of the liver, allowing some people to have a partial hepatectomy who otherwise might have been ineligible for the surgery. 

Whipple Procedure (Pancreatoduodenectomy)

The Whipple procedure is commonly used to treat extrahepatic bile duct tumors that are near the pancreas. It is also known as a pancreatoduodenectomy. The Whipple procedure involves removing part of the bile duct, part of the stomach, part of the small intestine, and the head (the rightmost section) of the pancreas. The remaining portions of the stomach, bile duct, and pancreas are then joined to the remaining small intestine so that digestive enzymes can mix with food. This ensures that the pancreatic fluids and bile will flow into the small intestine. Although this procedure is complex, it is safe and effective for many people. The Whipple procedure is also used to treat pancreatic cancer. Read more about surgery for pancreatic cancer.