World's first operation against bile duct cancer: patient triumphs over Erich!

World's first operation against bile duct cancer: patient triumphs over Erich!

The Hannover Medical School (MHH) used an innovative surgical technique to carry out a globally unique operation on bile duct cancer, which saved Susanne Viehmeier's life. In 2022, Viehmeier received the frightening diagnosis of bile duct carcinoma, which was deemed inoperable. She gave the tumor the personal name “Erich”, which reflects her strength and fighting spirit.

As part of her medical treatment, she was treated at the MHH in April 2023 and successfully left the clinic just eight days after her operation. Under the direction of Prof. Dr. Moritz Schmelzle, Director of the Clinic for General, Visceral and Transplantation Surgery at the MHH, the tumor, which had affected all three liver veins, was removed in a remarkable period of four and a half hours. This operation represented a significant advance in the treatment of bile duct cancer.

Innovative surgical technique

The novel technology that was used is based on an idea from Prof. Dr. Rudolf Pichlmayr and combines modern surgical procedures with extracorporeal membrane oxygenation (ECMO). This technique was used to maintain blood circulation while the liver was disconnected from the body's circulation. A perfusion device supplied the liver with an oxygen-rich nutrient solution and cooled it during the procedure.

Before the operation, the liver had to be split open to grow a lobe, part of a complex procedure that included experimental therapy. This led to a significant reduction in the size of the tumor, which significantly improved the operating conditions. The personalized treatment was made possible by the MHH's Molecular Tumor Board (MTB), which identifies genetic changes in tumors and organizes interdisciplinary tumor conferences.

Diagnosis and perspectives

Bile duct cancer, also known as biliary tumors, is increasing worldwide and is considered difficult to treat. The chances of recovery are usually poor, especially in advanced stages. Standard therapies include chemotherapy with gemcitabine and cisplatin. However, newer research approaches, such as the international KEYNOTE-966 study, show that the combination of immunotherapy drugs such as the checkpoint inhibitor pembrolizumab can improve the chances of survival. These results were published in the renowned journal “The Lancet” and show promising approaches to healing previously untreated metastatic or inoperable bile duct cancer.

The MHH is considered a supraregional Comprehensive Cancer Center (CCC) that offers special treatment options for complicated cases. In Germany, malignant tumors of the biliary tract occur in a significantly higher proportion of men, while gallbladder carcinomas occur more frequently in women. The incidence of gallbladder stones, considered the leading cause of gallbladder cancer, is also higher in women. However, very few patients with gallstones develop gallbladder carcinoma during their lifetime.

Susanne Viehmeier is in visible health after her procedure and plans to celebrate her 40th wedding anniversary in the fall. Her case illustrates the advances in modern medicine and the importance of personalized therapeutic approaches in the fight against cancer. These developments could be groundbreaking for many future patients with similar diagnoses.

Further information on treatment options for bile duct cancer can be found in the reports MHH, Ulm University Hospital and MHH.