Name of the Procedure:

Excision of bile duct tumor, with or without primary repair of bile duct; extrahepatic
Common names: Bile duct tumor removal, Extrahepatic bile duct excision

Summary

This procedure involves the surgical removal of a tumor located in the bile duct outside the liver. Depending on the situation, the bile duct may be repaired after the tumor is excised.

Purpose

This procedure addresses the presence of tumors in the bile duct, which can obstruct bile flow and cause various health issues. The goal is to remove the tumor and restore normal bile flow, potentially preventing further complications like jaundice or liver damage.

Indications

• Obstruction of the bile duct due to a tumor
• Symptoms such as jaundice, abdominal pain, and weight loss
• Diagnosis of bile duct cancer via imaging or biopsy
• Previous ineffective treatments (e.g., stenting)

Preparation

• Fasting for 8-12 hours before the procedure
• Blood tests, imaging (CT/MRI scans), and possibly a biopsy may be needed
• Adjustment or discontinuation of certain medications under doctor’s guidance

Procedure Description

1. The patient is administered general anesthesia.
2. An incision is made in the abdomen to access the bile duct.
3. The tumor is carefully excised from the bile duct.
4. If necessary, the bile duct is repaired, which may involve stitching or placing a stent to keep the duct open.
5. The area is checked for bleeding and proper bile flow is confirmed.
6. The incision is closed with sutures or staples.

Duration

The procedure typically takes between 2 to 4 hours, depending on the complexity and whether a bile duct repair is needed.

Setting

The procedure is performed in a hospital’s surgical department.

Personnel

• Surgeon specialized in hepatobiliary or gastrointestinal surgery
• Anesthesiologist
• Surgical nurses
• Operating room technicians

Risks and Complications

• Common risks: Infection, bleeding, adverse reactions to anesthesia
• Rare risks: Bile leakage, damage to nearby organs, blood clots
• Possible complications: Stricture or scarring of the bile duct requiring further interventions

Benefits

• Removal of the tumor can alleviate symptoms
• Restoration of normal bile flow
• Prevention of further complications such as jaundice or liver damage
• Potentially curative for bile duct cancer if caught early

Recovery

• Hospital stay typically lasts 5-7 days
• Pain management with prescribed medications
• Instructions on wound care, restricted activities, and dietary adjustments
• Follow-up appointments for monitoring recovery and detecting any complications

Alternatives

• Chemotherapy or radiation therapy: May be used in conjunction with or instead of surgery
• Endoscopic stent placement: Used to relieve bile duct obstruction without removing the tumor, may be temporary

Patient Experience

• During: The patient will be under general anesthesia and will not feel pain during the procedure.
• After: Postoperative pain and discomfort, managed with medications. Possible fatigue and need for support with daily activities initially. Emotional and psychological support may also be necessary.

Pain management and comfort measures include prescribed medications and following up on any signs of complications or side effects for prompt intervention.