At this stage, the cancer is confined to the bile duct. It is quite rare to find a bile duct cancer at this limited stage, for it would be unlikely to cause an obstruction of the bile flow when it is very small.
Standard Treatment Surgery can be done with hopes of a cure. The extent of surgery necessary depends on the tumor's location and size. It may be possible to remove a tumor limited to a small portion of either the right or left bile duct with its surrounding liver in a routine operation. But cancers involving the bile ducts at their junction within the liver require removal of liver tissue and then the complicated reconstruction of the bile drainage system. Tumors close to the intestine and pancreas may demand even more difficult surgery.
Whatever the extent of the surgery, tubes may have to be left within the bile duct system for a time to insure against bile leakage or the formation of scar tissue within the bile ducts.
It is not known whether drainage tubes should be placed through the bile duct blockage before surgery. If patients are ill because of the obstruction—the bile has become infected, for example—then a stent should be inserted to enable the patient to be in better condition for the surgery. Radiation to the tumor site is an alternative if patients are too sick to have surgery.
Unfortunately, even with meticulous surgery and careful screening , the majority of tumors will regrow within the bile ducts, in the nearby liver tissue or elsewhere in the body. So it is generally agreed that treating the surgical area with radiation after the tumor has been removed is useful in that it may help to destroy any remaining tumor cells .
