Surgical treatment of bile duct/gallbladder cancer can provide long-term survival. Twenty-five to thirty percent of patients with bile duct cancer are operable. There is a tendency for more aggressive surgical treatment.
Macroscopic and microscopic classifications of tumor growth are decisive for surgical treatment of gallbladder cancer. Involvement of lymph nodes in the hepatoduodenal ligament often occurs, but is not an absolute contraindication for surgery.
Definite signs of inoperability are:
- involvement of 2nd order of bile ducts
- peritoneal metastasis
- metastasis to aorta-caval lymph nodes
- distant metastasis
Chemotherapy is usually administered in the palliative setting.
Photodynamic treatment (PDT) may have a successful palliative effect for patients with inoperable bile duct cancer and obstructed bile ducts (2).
Palliative treatment in the form of endoscopic or percutaneous transhepatic dilatation or stenting is appropriate for symptoms caused by jaundice or cholangitis.