Bile Duct Cancer

The bile ducts are small tubes that connect the liver, gallbladder and small intestine. They are part of the digestive system.

What to expect from your appointments with us

Your initial appointment will most likely be in the Upper Gastrointestinal MDT clinic which happens every Thursday afternoon shortly after the multidisciplinary team meeting where all of these cancers are discussed.

You will meet one of the surgeons who will explain the diagnosis, results of tests and the plan for your further investigation and treatment. You will also meet the cancer nurse specialist and the specialist dietitian. The team is there to give you understandable information and answer any questions you may have.

What to expect from your diagnostic tests and investigations

Bile duct cancer is diagnosed following various tests. Your medical team may request some of the following tests and investigations:

• Blood tests – These will check your general health including your bone marrow, kidney and liver function
• CT scan - CT scans take cross sectional pictures of your body. This normally takes around 20 minutes. Intravenous contrast is often used to obtain images.
• MRI Scan – MRI uses magnetism and radio waves to create a 3-dimensional picture of the body. MRI is used to gather more information in patients being considered for surgery. The scan itself normally takes around 45 minutes to one hour. Intravenous contrast is often used to obtain images.
• Endoscopic ultrasound biopsy – This involves a thin flexible tube being used to look at your bile ducts and other digestive organs. The team will take samples of tissue which will be looked at under a microscope in our laboratory. This test is usually done under sedation, and you need someone to take you home afterwards.

Treatment options and what to expect

Your specialist team will advise which, if any, of the below are suitable for you:

Surgery - If your cancer is affecting the bile duct in the liver you will need a liver resection or hepatectomy. This is a major operation to remove part of your liver and can include removing the gall bladder. If the lower (distal) end of your bile duct is affected by cancer you may require surgery that is known as a Whipple procedure or PPPD. All surgery for bile duct cancer is performed at the regional liver and pancreas surgery centre in Birmingham. If you require surgery as part of your treatment, the Gloucester team will refer you to the Queen Elizabeth Hospital in Birmingham.

Chemotherapy - Chemotherapy is a cancer treatment where medicine is used to destroy cancer cells. It stops the cancer cells reproducing, which prevents them from growing and spreading in your body. If chemotherapy is recommended by your team, it will be delivered intravenously (directly into your vein).

You may hear the chemotherapy treatment being described as SACT, which means systemic anti-cancer therapies. This is a treatment that work throughout the entire body.

Contacts

Upper GI Clinical Nurse Specialist (CNS) team (hepatobiliary): 0300 422 6674

Cancer Support Workers: 0300 422 5374 / ghn-tr.uppergihnateam@nhs.net