Introduction
Some patients with bile duct cancer may not qualify for surgery. However, Dr Sanjoy Mandal, the best surgical oncologist in Kolkata, says that minimally invasive, image-guided procedures can help improve patients’ quality of life.
Procedures used to relieve Bile Duct Cancer Symptoms
Biliary Bypass
The biliary bypass connects the bile duct or gallbladder directly to the small intestine. This procedure creates a new channel for bile to bypass the tumour that blocks the flow from the bile duct. A biliary bypass is often performed by inserting a laparoscope (a thin tube with a light and a camera) in the belly, through a small cut in the abdomen.
Stent Placement
A stent is a small tube of expandable metal mesh coil. A stent can be placed through the blockage in two ways. An endoscope (a small tube-like instrument) can be inserted through the mouth and used to place a stent. The other method involves the placement of a stent with a needle inserted through the liver. In case of both ways, the blockage needs to be first identified with imaging. Some patients may need to have a catheter for a while after getting a stent.
Neurolytic Celiac Plexus Block
Advanced bile duct cancer can often cause pain as the cancer cells invade a cluster of nerves known as the celiac plexus near the liver. Suppose conventional drugs fail to relieve pain for people with advanced bile duct cancer. In that case, they may benefit from neurolytic celiac plexus block (NCPB). The procedure disrupts the body’s pain signals through an injection of local anaesthetic into the celiac plexus. Studies have shown that NCPB reduces pain and improves the quality of life for people with advanced bile duct cancer, says Dr Sanjoy Mandal, the best oncologist in Kolkata.
NCPB can be performed with a laparoscope or through the skin with a needle. However, the percutaneous (through the skin) method is associated with side effects, such as muscle and limb weakness. Laparoscopic NCPB, on the other hand, may provide similar or better pain relief than percutaneous NCPB with fewer side effects.
NCPB can also be performed by using endoscopic ultrasound. The procedure involves inserting a small probe into the stomach, through the mouth, to get a detailed view of the celiac plexus. Like laparoscopic NCPB, endoscopic NCPB may be as effective as the percutaneous approach, with few potential side effects.
Ablation
Ablation heat or cold through a needle placed into a bile duct tumour to kill cancer cells. The procedure requires no incisions and is effective for people with isolated tumours, says Dr Sanjoy Mandal, an oncology specialist in Kolkata.
Embolization
This technique involves the injection of microscopic beads into the blood vessels that feed the bile duct tumour to cut off its blood supply. This procedure can kill the tumour.