how complicated is bile duct removal surgery

When the gallbladder is removed, special clips are used to seal the tube that connects the gallbladder to the main bile duct. Your healthcare provider will need to determine whether surgery is the best option to treat your condition. Discussing the risks with your surgeon will help you decide whether to have surgery or not. Chest infections can also happen if you cant breathe deeply enough after your surgery. SA Khan and others This means bile or digestive juices can leak into surrounding tissues. Lancet Oncology. You may experience pain and jaundice (yellowing of the skin and eyes). Annals of Surgery. Content not working due to cookie settings. A stone that remains in a bile duct after gallbladder removal surgery can cause severe pain, or jaundice, which is the yellowing of the skin. . In general, a hepatectomy follows these steps: The procedure may take two to six hours, depending on the extent of the resection. Croome KP, et al. If the surgery successfully removes all of cancer, it can be curative. Philadelphia, Pa.: Saunders Elsevier; 2014. https://www.clinicalkey.com. You can unsubscribe at any Youll need to avoid alcohol to protect your recovering liver. June 10, 2016. Your healthcare provider will also need to decide whether a partial hepatectomy or a liver transplant is needed. Detailed diagnostics and sophisticated decision-making is always requiered. Clinical trials can't guarantee a cure, and they might have serious or unexpected side effects. AskMayoExpert. Your doctor and nurses will check for signs of heart problems after your operation. If you have part of your liver removed, it can grow back to its former size. Your doctor will drain abscesses or any fluid that has collected internally. It wants to return to a consistent size thats proportional to your overall body size. Cholangiocarcinoma 2020: The next horizon in mechanisms and management. If you smoke, stopping smoking now may reduce your risk of developing complications and will improve your long-term health. 161, pp. JM Banales and others 13 by Soper NJ and Strasberg SM, n3, at 66 (noting common bile duct injuries from failure to occlude the cystic duct, dissection performed too deeply, and cautery injuries); Jablonska B, Lampe P, Iatrogenic bile duct injuries, n1, at 4099 (noting injuries due to excessive dissection at the margins of the common bile duct during open procedures). If youre having open surgery, your surgeon will make one long incision across your abdomen to open your abdominal cavity. You will need someone's help for the first couple of weeks after discharge from the hospital. [12]While laparoscopic cholecystectomy has been a standard part of U.S. surgery residents' training for around a quarter of a century, with surgery residents having typically performed over 50 laparoscopic gallbladder removal surgeries by graduation, some older or foreign-trained surgeons may nonetheless lack the training or experience to be proficient in laparoscopy cholecystectomy. A complete . You can have up to two-thirds of your liver removed as long as the rest of your liver is healthy. Keywords: and transmitted securely. It may be a horizontal scar, or it might be shaped like an L. It may appear red and raised above your skin but usually, the color fades over time. 2013 Jan-Feb;33(1):117-34. doi: 10.1148/rg.331125044. A procedure to remove a sample of tissue for testing. Your surgeon will remove your gallbladder. . other information we have about you. Checking the level of carbohydrate antigen (CA) 19-9 in your blood may give your doctor additional clues about your diagnosis. Would you like email updates of new search results? Bergquist JR, et al. .st0 { Mayo Clinic; 2020. This review article discusses situation-dependent specific treatment of postoperative bile leakage as well as bile duct strictures and anastomotic stenosis in detail. There are well-reported reasons why surgeons inadvertently injure the common bile duct during gallbladder removal surgery. All rights reserved. So, surgery to remove the gallbladder is a very common operation for this condition. Choledocholithiasis is the most common cause of cholangitis, inflammation and infection of your common bile duct. Complications after bile duct surgery can be serious. The wound area may also become red and sore. Procedure After removal Takeaway Bile duct stents that stay in too long may cause complications. Advertising on our site helps support our mission. 55-59 (1995); Gigot J, Etienne J, et al, The dramatic reality of biliary tract injury during laparoscopic cholecystectomy: An anonymous multicenter Belgian survey of 65 patients, Surg Endosc. Surgery for bile duct cancer gives the best chance of curing. Some basic questions to ask your doctor include: In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask additional questions during your appointment. 1, pp. Pancreaticoduodenectomy. Its best suited for more complex procedures. Gallbladder surgery, also known as a cholecystectomy, is often recommended as the best treatment for pain associated with gallstones hardened deposits that form from bile, the liquid stored. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Review/update the pp. It works closely with the liver and ducts that carry bile. Getting enough protein and some gentle exercise (like walking) every day can help speed your recovery. enable-background: new; See also Prevention & Management of Laparoscopic Surgical Complications, The 1st Edition, Ch. Vol. Surgeons are able to visualize your abdomen directly. Does anything improve or worsen your symptoms? This is usually every 3 months if you have had surgery to remove bile duct cancer. and surgery involving the liver hilum or exposure of the intraparenchymal Glissonean sheath are risk factors for postoperative bile leakage. Like all operations there is a risk of problems or complications. It may be 12 weeks before you return to all of your normal activities. After surgery, your liver can quickly regenerate itself to its former size. Bile leaks are a rare but serious complication of gallbladder surgery. Surgery. 2005; doi:10.1097/01.sla.0000179678.13285.fa. You may also undergo placement of an epidural catheter or a spinal injection in addition to local nerve blocks to the abdominal wall. What is a bile duct drain? Bile moves through a network of tube-like structures called bile ducts. 13 by Soper NJ and Strasberg SM, n3, at 66; Malik AM, Laghari AA, Iatrogenic biliary injuries during laparoscopic cholecystectomy, A continuing threat, Int J Surg. 13 by Soper NJ and Strasberg SM, n3, at 66. They can also use robotic arms. You will not find any easy answers for dealing with cholangiocarcinoma, but some of the following suggestions may help: Make plans for the unknown. This meansbile or digestive juicescan leak intosurrounding tissues. This site needs JavaScript to work properly. Overall survival is increased among stage III pancreatic adenocarcinoma patients receiving neoadjuvant chemotherapy compared to surgery first and adjuvant chemotherapy: An intention to treat analysis of the National Cancer Database. About 2% of people who have liver resection surgery die of complications. Liver resection can be classified into major and minor liver resection. 2005 Feb;20(2):217-28. doi: 10.1111/j.1440-1746.2004.03490.x. PMC These problems are more likelywhen you are not moving around as you would normally. clip-path: url(#SVGID_4_); A high level of CA 19-9 in your blood doesn't mean you have bile duct cancer, though. Cancer.Net. 72, No. These procedures allow you to recover with minimal pain and discomfort after surgery and help to decrease the amount of narcotic pain medication you will need. CA 19-9 is a protein that's overproduced by bile duct cancer cells. include protected health information. 2016;114:475. Surgery may take four to 12 hours, depending on which approach is used and the complexity of the operation. When gallstones block the flow of bile out of the gallbladder, the gallbladder becomes swollen and inflamed. [13], Sometimes the way the surgeon retracts the gallbladder can result in parallel alignment of the cystic and common bile ducts, thus creating the illusion that the cystic duct is the common bile duct, and vice versa. The most serious of these is injury to the bile ducts. They can lead to bile leaking in the abdominal cavity, severe infection, and narrowing (stricture) of the duct that can result in liver cirrhosis and failure. the unsubscribe link in the e-mail. 2, pp. Some people develop liver failure after surgery. Tumors of the bile ducts, gallbladder and ampulla. 83-88 (Feb. 2002); Jablonska B, Lampe P, Iatrogenic bile duct injuries, n1, at 4097. The physiotherapists and nurses will help you get up and move around as soon as possible. Accessed Feb. 22, 2017. [11]Laparoscopic gallbladder surgery is unique: laparoscopic skills in one type of surgery,e.g. National Comprehensive Cancer Network. Gut, 2012. Epub 2020 Feb 17. Cholangioscopy is a safe and effective procedure when performed by an experienced interventionalist with an understanding of techniques to reduce complications. May 4, 2021. This operation removes a portion of your healthy liver to donate to someone who needs a liver transplant. Below is a short video showing breathing and circulation exercises after surgery. Infographic: Liver Transplant Bile Duct Cancer. Journal of Surgical Oncology. Youll have pain medication while you recover. Youll be sore and tired for a while. information highlighted below and resubmit the form. The treatment you need depends on what is causing the bleeding. Jabonska B, Lampe P, Iatrogenic bile duct injuries, n1, at 4098; Strasberg SM, Brunt LM, Rationale and Use of the Critical View of Safety in Laparoscopic Cholecystectomy, J Am Coll Surg. Palliative care specialists work with you, your family and your other doctors to provide an extra layer of support that complements your ongoing care. But traditional open surgery may be necessary to manage more extensive or complicated liver resections. 8 by Shayani V, Jacobs L, et al, Laparoscopic Cholecystectomy II, Soc of Laparoscop Surg., Operative Procedure, at: [url=https://laparoscopy.blogs.com/prevention_management/2006/01/chapter_8_lapar.html]https://laparoscopy.blogs.com/prevention_management/2006/01/chapter_8_lapar.html[/url]. Is a clinical trial for biliary tract cancer right for me? [] What causes gallstones? There is a problem with The location and size of your incision varies according to your surgeon's approach and your particular situation. 2015 Oct;39(10):2543-9 They offer access to treatments that wouldn't otherwise be available to you. If you need to cough, support your wound with your arms, a pillow or a rolled up towel. [16]Patients who have iatrogenic bile duct injuries from laparoscopic procedures normally have more severe injuries than those who are injured in open surgery, and prompt recognition of the injury (including with cholangiogram) is required so that surgical reconstruction of the biliary duct/tract can occur before the foregoing complications can develop. pp. Talk to your treatment team, family and friends if you feel stressed, worried or depressed. Complex liver surger A Whipple procedure may be done in various ways: Minimally invasive surgery offers some benefits, such as lower blood loss and a quicker recovery in those without complications. 4097 4104, at 4097-98 (Sep. 7, 2009). Laparoscopic and robotic surgeries are less invasive because theyre done through smaller incisions usually four to six small incisions, each about a half-inch in size. What will that cost, and will my insurance cover it? Phillips EH, et al, Operative Strategies in Laparoscopic Surgery, Ch. Liver resection is considered a technically difficult surgery. The portion of liver that needs to be left behind depends on how damaged the liver is overall. A bile duct drain is a procedure that involves opening up obstructions or treating holes in the biliary system. Coming to a Cleveland Clinic location?Hillcrest Cancer Center check-in changesCole Eye entrance closingVisitation and COVID-19 information. Accessed June 3, 2016. Mayo Clinic, Rochester, Minn. Feb. 22, 2017. J Banales and others Therapeutic strategies for bile leakage comprise conservative watch and wait, interventional procedures (endoscopic or percutaneous biliary drainage) and relaparotomy and are selected based on the postoperative onset, output volume and anatomic localization of the bile leak. A Whipple procedure also known as a pancreaticoduodenectomy is a complex operation to remove the head of the pancreas, the first part of the small intestine (duodenum), the gallbladder and the bile duct. [18] The patient who experiences bile duct injury will commonly experience yellowing of the skin (jaundice), fever, chills, and abdominal pain. 2016;20:891. The team is made up of pancreatic surgeons, specialized surgical nurses, anesthesiologists and anesthetists doctors and nurses trained in giving medication that causes you to sleep during surgery and others. You can help to prevent chest infections by doing deep breathing exercises. Explore Mayo Clinic studies of tests and procedures to help prevent, detect, treat or manage conditions. 5th ed. 8600 Rockville Pike Anderson CD. 0300 123 6200. Before offering surgery, your doctor makes sure the benefits of having the operation outweighs the risks. They may use an intra-operative ultrasound to map your liver. Management of iatrogenic bile duct injuries: role of the interventional radiologist. The remaining organs are reattached to allow you to digest food normally after surgery. Detailed diagnostics and sophisticated decision-making is always requiered. 2020; doi:10.1002/hep.31146. Pancreas. Bleeding in the few days following surgery can happen because of an infection or a fistula forming. Unlike a cholecystostomy, removing the gallbladder during these times was associated with inadvertent surgeon-caused (i.e. This may depend on: To screen you for these factors, your healthcare provider may want to run some tests, including: Hepatectomy can be performed by open, laparoscopic or robotic surgery. 2016;45:1461. Epub 2013 Aug 26. The tube stays in until the fistula dries up. Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition. Older adults and people with significant health concerns may require a temporary stay in a skilled rehabilitation facility. Implications of CA-19 elevation for survival, staging, and treatment sequencing in intrahepatic cholangiocarcinoma: A national cohort analysis. When possible, surgeons try to remove as much of the cancer as they can. Can I have a copy of the pathology report? Your healthcare provider will give you instructions about how to care for your incision as it heals. 170, pp. Phillips EH, et al, Operative Strategies in Laparoscopic Surgery, Ch. AskMayoExpert. A biopsy is a procedure to remove a small sample of tissue for examination under a microscope. In: Netter's Surgical Anatomy and Approaches. If you have a total hepatectomy, you will need a liver transplant. Riggin EA. Sometimes bile can crystallize and form stones in the gallbladder or in the ducts that run to and from the gallbladder. A liver resection, or hepatectomy, is a surgical procedure to remove part of your liver. Accessed. If youre having laparoscopic surgery, your surgeon will make 4 to 6 keyhole incisions, which theyll use to place the camera (laparoscope) and surgical instruments to do the operation. 1998). Don't hesitate to ask about your surgeon's and hospital's experience with Whipple procedures and other pancreatic operations. Cholangiocarcinoma (primary liver cancer). Clinical trials are studies to test new treatments, such as new drugs and new approaches to surgery. Other types of pancreatic operations also may be performed, depending on your situation. If the treatment being studied proves to be safer and more effective than are current treatments, it can become the new standard of care. Shubert CR, et al. A more damaged liver may take longer to regenerate. Breathing and circulation exercises after surgery. Accessed May 28, 2021. The Whipple procedure is a difficult and demanding operation and can have serious risks. Indian J Gastroenterol. -, Ann Surg. Accessed Jan. 14, 2021. Imbalances in the substances that make up bile cause gallstones. This can result in severe abdominal pain, usually on the right side. It is the most often used surgery to treat pancreatic cancer that's confined to the head of the pancreas. information submitted for this request. Disclaimer. https://www.nccn.org/guidelines/guidelines-detail?category=1&id=1438. You may also receive some medication to help you relax if you are nervous. However, this surgery is often lifesaving, particularly for people with cancer. National Comprehensive Cancer Network. information and will only use or disclose that information as set forth in our notice of An ultrasound device at the end of the tube emits sound waves that generate images of nearby tissues. The video is 2 and a half minutes long. If your bile duct is damaged or diseased, your consultant may recommend bile duct resection (removal). Symptoms of a bile leak include tummy pain, feeling sick, a fever and a swollen tummy. These things may all involve medical or surgical malpractice. A healthy liver may be able to lose up to two-thirds of its volume and still recover. A fistula may develop from the bile duct or pancreas after surgery. Delaney CP. If something is blocking the bile duct, bile can back up into the liver. This is used to inject fluid and medication into your veins as needed. Philadelphia, Pa.: Churchill Livingstone Elsevier; 2014. http://www.clinicalkey.com. Small cell carcinoma of the pancreas: A surgical disease. The most frequent reason for iatrogenic injury to the common bile duct in gallbladder removal surgery is that the surgeon misidentifies the common bile duct as the cystic duct. A biliary drain (also called a biliary stent) is a thin, hollow, flexible tube with several small holes along the sides. 2016;151:e161137. Some people develop heart problems after surgery that they did not have before. You may have a liver resection to treat liver disease, or when you want to donate part of your liver for living donor liver transplantation. A small hole anywhere along the bile ducts can cause bile to leak into the abdominal cavity. Search our clinical trials database for all cancer trials and studies recruiting in the UK, Questions about cancer? How will my treatment affect my daily life? [4]It is performed much more often than open surgery to remove the gallbladder because it offers smaller scarring, less discomfort, quicker recovery, and shorter hospital stays. -, Am Surg. This may include variationssuch as a short or absent cystic duct, a cystic duct tethered to the common bile duct, or a cystic duct entering the nearby hepatic duct before joining the common bile duct. Bile leaks are often corrected by placing a stent (narrow tube) in the duct to keep bile from escaping while the duct heals. Your surgeon will finely dissect your liver tissue, isolating the blood vessels and bile ducts and controlling them with metallic clips or staplers. 11th ed. 2014 Apr;16(4):312-9. doi: 10.1111/hpb.12151. If we combine this information with your protected You can do these exercises in a bed or in a chair. Some basic facts and statistics about gallstones are illustrated in this chart: As seen in the chart, medication and diet may help some people to avoid further gallstone or gallbladder disease, but many people require some form of medical or surgical intervention for the problem. Your surgeon will review several factors to evaluate which approach to your surgery is best in your situation. Carcinoma of the pancreas. Clots can block the normal flow of blood through the body. 5, pp. On the other hand, cancer clinical trials are closely monitored to ensure they're conducted as safely as possible. Nuts. Bile Leak. [6] So, instead of cutting where he or she is supposed to, at the cystic duct, the surgeon instead cuts the common bile duct. 570-73 (2000). 33, pp. The gallbladder is a small organ under your liver. The attorneys at Clore Law Group have significant experience and expertise with handling general surgery, gallbladder surgery, and common bile duct injury malpractice cases to successful resolution. HHS Vulnerability Disclosure, Help Chest infections and blood clots are possible complications after any surgery. A leak can happen in the area where the bile ducts are stitched back together or the cut surface of the liver. If you are struggling to clear any phlegm, try a hu. If you have open surgery, you will have a long scar thats 6 to 12 inches. Vol. But it also takes longer, which can be hard on the body. It can root out diseases, including cancer. Endoscopic ultrasound (EUS). A chest infection happens when you cant move around as much as usual. 1171-1178 (1997). The patient's condition of course worsens without timely recognition and proper repair of the injury. [19] Nevertheless, even after bile duct reconstruction and repair a patient may still be left with significant and permanent gastrointestinal problems and may develop chronic problems like strictures or even life-threatening conditions such as bile duct infection (cholangitis), or an inflamed pancreas (pancreatitis).[20]. World Journal of Surgical Oncology, 2020. A common complication resulting from this condition is jaundice. The morning of surgery, you'll check into the admission desk and register. After your Whipple procedure, you can expect to: After discharge from the hospital, most people can return directly home to continue recovery. Another tube, called a urinary catheter, will be inserted into your bladder. the unsubscribe link in the e-mail. You will then need to change into a surgical gown in preparation for surgery. If the suspicious area is within or near the liver, your doctor may obtain a tissue sample by inserting a long needle through your skin to the affected area (fine-needle aspiration). Guidelines for the management and treatment of cholangiocarcinoma: an update PLoS ONE. What are the potential side effects of each treatment option? You also have medicines to control swelling (inflammation). Vol 17, Pages 557-588, Cholangiocarcinoma: current knowledge and future perspectives consensus statement from the European Network for the study of cholangiocarcinoma (ENS-CCA) 20th ed. 5, pp. This test is the one most commonly used to look for signs of gallstones. In cases where the anatomical variation creates doubt, intraoperative imaging (cholangiogram) with dye may be used to better visualize the ductal network, or the surgeon may need to obtain help from another or more experienced surgeon, before proceeding further. An injured common bile duct can leak bile . Among the numerous steps of the procedure, the surgeon has to dissect the cystic duct from the gallbladder to detach and remove it, while leaving the common bile duct intact and unharmed. They will free up and secure your gallbladder duct (cystic duct) and artery, separate your gallbladder from your liver, and remove it. They use specially designed, long instruments to complete your liver resection. 211, No. In intensive care, your healthcare team will closely monitor your fluid/electrolyte balance, blood glucose levels and blood loss. Sign up for free and stay up to date on research advancements, health tips, current health topics, and expertise on managing health. Jabonska B, Lampe P, Iatrogenic bile duct injuries, n1, at 4097. Journal of Gastrointestinal Surgery. Vol. 290, No. Niederhuber JE, et al., eds. In certain situations, difficult visualization may require the surgeon to convert to an open procedure rather than to risk cutting in the face of poor exposure.[14]. The pancreas releases (secretes) enzymes that help you digest food, especially fats and protein. Lippincott, Williams and Wilkins, 2015, Cholangiocarcinoma 2020: the next horizon in mechanisms and managements Bookshelf Cancer patients weigh these risks against the risks of cancer itself. Bile ducts are the drainpipes that connect your liver, pancreas and gallbladder, allowing bile to digest food and cleanse the organs of waste. While the bile duct injury can occur as a result of surgeon malpractice due to poor surgical technique or technical factors,[8]the injury occurs 70% - 80% of the time because the surgeon misidentifies the anatomy before clipping, cutting or suturing. Get useful, helpful and relevant health + wellness information. Dent TL, Training and privileging for new procedures, Surg Clin North Am. Biliary dilation occurred whether or not patients had previously . Possible locations of bile-duct tumors For gallstones, a doctor may use the procedure to remove a stone from a. The goal of partial liver resection is to remove the diseased part of your liver (with a safe margin around any cancerous tumor) while leaving enough liver behind to keep up with all the work your liver has to do. Depending on your situation, your doctor may talk with you about other pancreatic operations. Nature Reviews gastroenterology & hepatology, 2016. Elsevier; 2021. https://www.clinicalkey.com. If this happens, your doctor puts in a tube to drain it. Talk with your doctor about concerns you may have about your surgery and various other treatment options either before or after your operation. HPB (Oxford). Accessed Jan. 14, 2021. Your doctor is likely to ask you a number of questions, such as: Cholangiocarcinoma (bile duct cancer) care at Mayo Clinic. 4, pp. When liver cells detect damage, they communicate with each other to begin dividing and replicating themselves until that size is reached. They usually do this by using an x-ray or ultrasound to help guide a needle or tube into place. 615-621 (1996); Parsa CJ, Organ CH, Jr., et al, Changing patterns of resident operative experience from 1990 to 1997, Arch Surg. Youll gradually resume eating solid food, begin to move around more and your provider will remove the tubes. Pancreatic cancer. When did you first begin experiencing symptoms? Your doctor and nurses will check for signs of bleeding after surgery. Other complications from gallbladder surgery are rare. Laparoscopic vs open pancreaticoduodenectomy: Overall outcomes and severity of complications using the Accordion Severity Grading System. Your chances of long-term survival after a Whipple procedure depend on your particular situation. 2016;160:1080. 2015 Jul;86(7):682-6 Once youve stabilized, you'll continue to recover in the hospital for up to a week. Overview What is bile, and what is bile duct exploration? Mayo Clinic Q and A: What is cholangiocarcinoma and how is it treated? 2012;215:810. Biliary tract cancer: Should I get a second opinion? For the best browsing experience please enable JavaScript. If you dont receive our email within 5 minutes, check your SPAM folder, then contact us Yamada A, et al. The Whipple procedure (pancreaticoduodenectomy) is an operation to remove the head of the pancreas, the first part of the small intestine (duodenum), the gallbladder and the bile duct. } This is the only treatment that can lead to prolonged survival and cure for most of these tumors. Effect of statins on the risk of extrahepatic cholangiocarcinoma. Allscripts EPSi. If the section to be removed is close to your. 13 by Soper NJ and Strasberg SM, n3, at 65; Dziodzio T, Weiss S, et al, A critical viewon a classical pitfall in laparoscopic cholecystectomy, Int J Surg Case Rep. Vol. To provide you with the most relevant and helpful information, and understand which If you are a Mayo Clinic patient, this could After discharge, youll make an appointment to revisit your surgeon in two weeks to check your final pathology report and discuss how youre doing. If you have any doubts, get a second opinion. How can I prepare myself for the operation? You have heart tests before your surgery to make sure your heart is able to cope with the operation. Try to walk for at least 30 minutes each day, but rest when you need to. Surgical resection of lesions of the head of the pancreas. The surgeon makes an incision in your abdomen to access your internal organs. Talk to your doctor about what clinical trials might be appropriate for you. 2001 Jan;233(1):45-50 These exercises help prevent you developing a chest infection or blood clots in your legsafter surgery. December 2 2018 Gallstone disease can be traced to ancient times. Risk of gastrointestinal cancers in patients with cystic fibrosis: A systematic review and meta-analysis. Accordingly, the surgeon has to be very careful to identify conclusively the ducts before he cuts. When the aim is to try to cure your cancer, you and your doctor may feel it is worth taking some of these risks. Sometimes a procedure may begin with minimally invasive surgery, but complications or technical difficulty require the surgeon to make an open incision to finish the operation. Even worse, this can result in infection, and other signs or symptoms such as nausea, vomiting, chills and fever.

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how complicated is bile duct removal surgery