Patient: The patient was hospitalized in September 2009 with sudden abdominal pain, no fever, no jaundice, and felt normal after the abdominal pain, and was considered to have an occupying lesion in the neck of the gallbladder. In December, the ultrasound showed normal and the tumor markers were normal. What kind of help do we need: Do we need chemotherapy or Chinese medicine to prevent this? This is why a portion of the bile duct was removed and a bile-intestinal anastomosis was performed. We also need to know whether there is liver infiltration, duodenal infiltration, metastasis in the hilar and peripancreatic lymph nodes, and the detailed scope of surgical resection. If pathology confirms the presence of lymph node metastasis (which is very common in gallbladder cancer), in principle, appropriate radiotherapy or chemotherapy should be considered, together with immunotherapy and traditional Chinese medicine, please consult your specialist for the specific plan. It is also recommended to check the enhanced CT of the liver. Patient: Please ask Prof. Zhang to give us a clear treatment plan for the next step! We really don’t know what to do, my mother had surgery at the end of September 2009 and has not used any medicine since then. Professor Zhang, what should we do now? Is chemotherapy still effective if my mom is undergoing it now? Do we need to consult a Chinese medicine doctor for immunotherapy and herbal treatment as you said? I wonder if Prof. Zhang can leave a phone number or other contact information? Hepatobiliary Surgery Department of Hepatobiliary Hospital: The description of the surgical method is reasonable, and there is no tumor residue in the upper and lower bile duct margins, suggesting that the resection scope meets the requirements. There is really no accepted and authoritative chemotherapy regimen for bile duct cancer, and the current treatment is basically empirical recommendations. For patients with satisfactory surgery but lymph node metastasis, we generally recommend appropriate radiotherapy and chemotherapy, and the effectiveness of which cannot be fully confirmed beforehand. Your mother’s lymph node metastasis is not conclusive, but she should have regular CEA, CA19-9 and, if necessary, liver CT. Chinese herbal medicine regulation of course should go to see a Chinese medicine doctor, while immunotherapy is currently mainly injections of Alpha 1 thymidine, but imported preparations are very expensive, and discretion is appropriate to decide whether to use. Patient: Are you talking about the 5-fu tablets similar to chemotherapy? Is there a lot of side effects from taking this drug for a long time? In your opinion, is chemotherapy or oral medicine better? Once again, please! Hepatobiliary Surgery Department of Hepatobiliary Hospital: 5-Fu is the basic drug for treating gastrointestinal tumor. When there is no other exact effective drug, the appropriate use of 5-Fu-based preparation is one of the methods of follow-up chemotherapy. It is hard to say that other much more expensive drugs have better effect, so the former is recommended. 5-Fu is the cheapest oral chemotherapeutic agent available. In our experience, there are no specific side effects with long-term administration.