Cancer that starts in the inner lining of the gallbladder is called as gallbladder cancer. Gallbladder cancer is difficult to diagnose at their early stages as they are often asymptomatic. When found early there is a good chance for it to be completely cured. When found at a later time, very often, the prognosis is very poor.
CT Scan /PET-CT/ MRI Scan is done to access the extent of spread. Depending on the stage of the disease, after discussing it in a multidisciplinary tumor board, treatment protocol decided. Sometimes cancer detected incidentally after a cholecystectomy (gallbladder removal surgery) in the biopsy report. These patients should undergo staging workup and then surgery if required.
Treatment depends on the extent of the spread and condition of the patient. Various treatment modalities (like surgery, chemotherapy, endoscopic stent placement in the bile duct) are used alone or in combination.
Gallbladder cancer patients with localized disease should undergo radical cholecystectomy. Staging laparoscopy should be done to rule out any spread at the beginning of surgery. Through a small hole, laparoscope (tube with camera and light) inserted and internal organs are examined for any spread of cancer. In radical cholecystectomy, Gallbladder along with adjacent liver and lymph nodes are removed. Bile duct excision may be required in some. If the tumor is located near the neck of the gallbladder, extensive liver resection is required.
If the tumor already spread, palliative care is the choice. Here cure is not possible. Relieving the symptoms and giving a better quality of life is the goal. Chemotherapy is recommended in patients with adequate performance status. Jaundiced patients may require the insertion of a stent (tube) in bile duct. Metal stents are preferred than plastic stents for palliative purposes as they have long term patency.
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