Surgery is the only treatment that can cure bile duct cancer (cholangiocarcinoma). Doctors can also use surgery to provide symptom relief or combine it with other cholangiocarcinoma treatments to improve outcomes.
At Penn Medicine, our gastrointestinal (GI) surgeons specialize in procedures that treat these rarer cancers, including bile duct removal and partial hepatectomy. They are in constant communication with other members of our experienced GI cancer team to ensure you receive effective, coordinated care.
Cholangiocarcinoma Surgery: Why Choose Penn Medicine?
Bile duct cancer surgeries are complex and uncommon operations. It is important to choose experienced surgeons who routinely do these procedures Patients who choose to have bile duct cancer surgeries at high-volume centers like Penn do better.
When you come here, you also benefit from:
- Elite surgeons: Surgeries to treat bile duct tumors may involve other nearby organs, such as the liver and pancreas. Our GI surgeons are among the most experienced in the country in these procedures. Their skill leads to better outcomes for our patients and more options for hard-to-treat cancers. Meet our GI surgery team.
- Minimally invasive options: We offer effective alternatives to open surgeries, including minimally invasive procedures with tiny incisions. These techniques mean smaller scars and less painful, shorter recoveries.
- Complete care: Cholangiocarcinoma treatment often requires more than one therapy or surgery. In our weekly GI tumor board meetings, bile duct cancer experts from all areas of medicine come together to discuss treatment approaches and difficult cases. Together, they ensure your care plan is comprehensive and informed by the latest advances.
- Outstanding outcomes: Our patients experience low rates of complications and excellent results after bile duct cancer surgery. Even patients with more challenging cancers, including advanced cholangiocarcinomas, experience these great outcomes.
- Advanced treatments: We give you special access to advanced cholangiocarcinoma treatments not available at most centers in the region. These treatments include liver transplant and hepatic artery infusion pumps. Hepatic artery infusion pumps treat intrahepatic cholangiocarcinomas, (bile duct tumors in the liver). These small pumps deliver concentrated doses of chemotherapy directly into your liver to treat advanced tumors.
- Clinical trials: Our clinical trial program gives patients early access to breakthrough therapies and provides additional options for inoperable tumors.
- Flexibility: You can have bile duct cancer surgery at one of three convenient locations across downtown Philadelphia and other locations throughout the region.
Types of Bile Duct Cancer Surgeries
Surgeons can remove some bile duct tumors if they are found early. But the more advanced the cancer, the less likely you can be cured with surgery alone. Read more about bile duct cancer treatment.
Bile duct tumors are categorized as resectable (removable) or unresectable. If the tumor is unresectable, a liver transplant may be an option. We are one of just a few places in the region offering liver transplants to treat cholangiocarcinomas. Learn more about our Penn Liver Transplant Program.
Surgeries for removable bile duct cancers include:
Staging (Diagnostic) Laparoscopy
During a staging laparoscopy, your surgeon can get a better understanding of how advanced the cancer is. To do this, your surgeon makes a tiny incision in your belly button and inserts a laparoscope (flexible tube with a camera at the tip).
This process allows the surgeon to see areas of cancer spread. With this information, your doctors can personalize your care and fine-tune your treatment plan. Find out more about our bile duct cancer diagnostic tools and tests.
Bile Duct Resection (Removal)
If the tumor is small and located outside the liver, your surgeon may be able to remove some or all of the bile duct it's located in. Then, your surgeon makes a new duct by connecting the remaining bile duct to the intestine. A bile duct removal may also involve taking out nearby lymph nodes to check for cancer.
Partial Hepatectomy (Liver Resection)
For intrahepatic (bile ducts inside the liver) bile duct cancers and more extensive extrahepatic (bile ducts outside of the liver) tumors, a partial hepatectomy may provide the chance for a cure. During a partial hepatectomy, your surgeon removes the portion of your liver that has the bile duct cancer along with some surrounding tissue.
Partial hepatectomies are major surgeries that require skilled surgical teams for successful outcomes. Our surgeons are among the most experienced in the Philadelphia region performing these complicated procedures. In our high-volume program, they complete more than 100 liver resections each year and deliver great outcomes.
Learn more about liver cancer surgery at Penn.
Whipple Procedure (Pancreaticoduodenectomy)
A Whipple procedure is a complex surgery: Surgeons remove the head of the pancreas, part of the bile duct, the duodenum, the gallbladder, possibly a portion of the stomach and nearby lymph nodes.
At Penn, our skilled surgeons perform about 100 Whipple procedures every year — which is among the most in the U.S. Our patients also experience outcomes that are among the best in the country. Learn more about the Whipple procedure and pancreatic cancer surgery.
Palliative Surgery for Bile Duct Cancer
Doctors can perform procedures to address bile duct cancer complications and relieve symptoms. These surgeries include:
- Surgical biliary bypass: To restore the flow of bile (digestive fluid) from the liver, doctors make a new route around a blockage caused by a tumor.
- Bile duct stent placement: When a tumor blocks a bile duct, doctors can place a stent (tube) into the bile duct to keep it open.
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