Biliary tract cancer
Treatment options in Shanghai

For an intrahepatic tumor, surgery may remove part of the liver together with appropriate nearby structures and lymph nodes. Planning must consider tumor distribution and whether removal can leave a working liver with adequate blood supply and bile drainage. A lesion that appears large on one image is not classified by diameter alone; multiple tumors, vessel involvement, lymph nodes and distant spread can change the plan. Ask the surgeon to show the intended resection on your imaging and explain which structures must be preserved. When surgery is not appropriate, the oncology discussion should explain the alternative treatment's purpose.

Perihilar tumors sit where bile drainage from the two sides of the liver converges, close to important vessels. Assessment therefore needs more than the length of the visible narrowing. It asks how far disease extends along the ducts, which vessels are involved and which side of the liver could remain after surgery. Resection may involve bile ducts and part of the liver, followed by reconstruction of drainage. Ask whether additional imaging or preparation is required before a definitive recommendation, and which specific anatomical finding limits surgery if the case is considered unresectable. “Near the hilum” alone is not an operative plan.

A distal bile duct tumor may require pancreaticoduodenectomy, commonly called a Whipple operation, because of its position beside the pancreatic head and duodenum. This removes and reconnects parts of the digestive system; it is not simply cutting out a short piece of duct. Discuss the intended reconstruction, eating and weight recovery, and risks such as bleeding, infection or leakage at a surgical connection. A small tumor may still require a substantial operation because location determines access and margins. Conversely, the operation should not be assumed necessary until the team confirms the diagnosis, stage and ability to tolerate it.