What is it?
A tumor that forms in the wall of the gallbladder is the most common neoplasm of the bile ducts. Gallstone disease (gallstones) is detected in 70-98% of patients with gallbladder cancer. Probably, chronic inflammation of the gallbladder wall leads to the phenomena of dysplastic transformation of the epithelium up to the development of the carcinoma. However, the risk of developing gallbladder cancer in patients with gallstone disease does not exceed 0.5-2%.
How is it diagnosed?
The detection of a tumor is often accidental during histological examination after removal of the gallbladder due to gallstone disease (10% of cases). At a later stage, the cancer can grow into the liver and the main bile ducts, causing jaundice and abnormalities in blood tests for liver function. The diagnosis is usually made during ultrasound and contrast CT of the abdominal cavity.
How is it treated?
The preferred treatment is surgical removal of the tumor. Depending on the stage of the disease, more aggressive intervention may be recommended: if the tumor is limited to the most superficial layer of the gallbladder wall, removal of the gallbladder only (cholecystectomy) is usually considered sufficient. This often happens when a tumor is accidentally detected after a cholecystectomy performed for cholelithiasis. For more severe stages with infiltration into the deeper layers of the gallbladder wall or surrounding liver, resection of the part of the liver surrounding the gallbladder (segment IV) and regional lymph nodes is recommended. Therefore, in the case of accidental detection of gallbladder cancer after cholecystectomy performed for cholelithiasis, it is necessary to perform an additional operation to radically remove the neoplasm.
If the tumor also infiltrates the cystic duct and the main bile duct, it may also be necessary to remove the bile duct and conduct a biliodigestive shunt; if the tumor affects the main blood vessels of the liver lobe, a more extensive liver resection (right or left hepatectomy) is required.
Patients with a tumor that cannot be surgically removed at diagnosis have a disappointing prognosis, since chemotherapy and radiation therapy have not currently shown effectiveness in treating this disease.
Where do we treat it?
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