How to treat bile duct tumors

Biliary duct tumors are divided into benign and malignant. Due to the special location of the bile duct and its hidden nature, it is not easy to be detected. Once detected, it is often in the middle or late stages, so the mortality rate is still very high. Biliary duct tumors are common in Asia, especially in Japan, where the incidence rate is very high, and is higher in women than in men. Benign bile duct tumors can be completely cured through surgery and are not life-threatening. Malignant bile duct tumors are easily misdiagnosed and missed.

The treatment of bile duct tumors depends on the cause and the condition of the tumor. Surgery is the most direct way to find out the type of tumor, decide whether the tumor can be removed, and establish a bile drainage bypass. The most common situation is that the tumor cannot be completely removed. Moreover, most of these tumors are not sensitive to radiotherapy. Chemotherapy can sometimes relieve some symptoms.

Some patients with cancerous biliary obstruction experience pain, itching, and abscesses caused by bacterial infection. If their condition does not allow surgery, Doctors use the fiberoptic endoscope to insert a tube (bypass) to allow bile and pus to drain away from the tumor. This method can not only drain the accumulated bile and pus, but also control pain and relieve itching.

Preoperative care

1. Psychological care creates a good treatment and recuperation environment for patients and completes the patient's role transition as soon as possible. Patients with bile duct tumors suffer from heavy mental burdens and depression due to pain, jaundice and other reasons. Patients should be encouraged to talk to eliminate anxiety, fear and tension, and build confidence in recovering their health; at the same time, communication should be strengthened and the progress of diagnosis and treatment of the disease should be introduced; the operation should be standardized and proficient to increase mutual trust; the surgical method and possible situations should be explained to the patient to reduce the anxiety and pressure caused by understanding the condition.

2. Improve nutrition and strengthen liver protection treatment. Due to the toxic effects of bilirubin and bile salts, patients with obstructive jaundice suffer from liver cell damage and fibrosis, which eventually lead to biliary cirrhosis and liver function damage. At the same time, bile cannot enter the intestine, which reduces the digestion and absorption capacity and fat-soluble vitamin absorption, liver cell metabolism capacity, and protein synthesis capacity, which can lead to poor overall nutritional status, ascites, hypoproteinemia, and decreased tolerance to surgery. Before the operation, the patient should cooperate with dietary care and eat a high-sugar, low-fat, high-quality protein, vitamin-rich and easily digestible diet to improve the patient's nutritional status and enhance surgical tolerance. If necessary, enteral or parenteral nutrition can be carried out in cooperation with the physician. Generally, the total serum protein should reach 65g/L and the albumin should reach 35g/L before surgery.

3. Closely observe vital signs, consciousness, and changes in urine volume. Patients with bile duct tumors may suffer from endotoxemia due to obstructive jaundice, which may aggravate the functional damage of important organs such as the liver and kidneys, leading to hepatorenal syndrome. Therefore, the patient's condition should be carefully observed, water, electrolyte and acid-base imbalances should be corrected, and the 24-hour intake and output should be accurately recorded.

4. Observe the changes in the patient's abdominal symptoms and signs. Observe the nature and location of the abdominal pain, whether there is radiating pain, etc. For patients with cholangitis secondary to bile duct tumors, the condition often worsens. Pay more attention to changes in body temperature, jaundice and peritoneal irritation signs. Give anti-infection drugs in time according to the doctor's orders to control bile duct infection.

5. Hyperbilirubinemia and endotoxemia in malignant obstructive jaundice can weaken the liver's compensatory and reserve functions, and reduce the body's immunity and surgical tolerance. If necessary, you should cooperate with the physician to perform preoperative jaundice reduction and drainage, such as PTCD, and closely observe the disappearance of jaundice and laboratory test results. Generally, radical surgery is performed when the blood bilirubin drops below 171 μmol/L and the general condition improves.