Abstract
Biliary cancer causes distinctive symptoms dependent on the location of the tumor. Understanding of these cancer-related symptoms is helpful for optimal palliative care. In this article, common problems and management are described; cancer-related pain, duodenal obstruction, obstructive jaundice, biliary infection, pruritus and vitamin K deficiency. The choice of opioids for biliary cancer is also stated as a topic, though they should be used cautiously in patients with liver dysfunction. Sphincter of Oddi dysfunction related to opioids is discussed as a noteworthy issue. In palliative care, setting some procedures such as celiac plexus block, duodenal stent placement and PEG for decompression would be effective. These interventions would provide more palliative care options for clinicians. It is important for healthcare workers to pay much attention not only to physical suffering but also to other kinds of sufferings known as total pain. In decision-making at clinical settings, QOL and satisfaction of patients' and their families should be considered.
