Gallbladder Cancer
A rare but aggressive cancer that starts in the gallbladder wall, often discovered at advanced stages.
Overview
Gallbladder cancer is the most common biliary tract malignancy and is particularly common in North India. It's often detected incidentally after cholecystectomy for gallstones. Early-stage disease is curable with radical surgery, but advanced disease carries a poor prognosis. Dr. Bhagat's research includes PET-CT accuracy in resectable gallbladder carcinoma.
Causes
- Gallstones (strongest association)
- Porcelain gallbladder (calcified wall)
- Gallbladder polyps >10mm
- Anomalous pancreaticobiliary duct junction
- Chronic gallbladder inflammation
- Salmonella carrier state
Risk Factors
- Female gender (3:1)
- Age over 65
- North Indian ethnicity
- Large gallstones (>3cm)
- Porcelain gallbladder
- Obesity
- Gallbladder polyps
- Family history
Symptoms
Diagnosis
- Ultrasound abdomen
- CT abdomen with contrast (staging)
- PET-CT (for distant metastasis)
- MRCP (biliary anatomy)
- CA 19-9 and CEA markers
- Incidental finding after cholecystectomy (histopathology)
- Diagnostic laparoscopy (rule out peritoneal disease)
Treatment Options
Surgical Treatment
For T1b and above stages, radical cholecystectomy is needed: removal of gallbladder with 2cm liver margin (segments IVb+V) and regional lymphadenectomy (hepatoduodenal ligament). If bile duct is involved, bile duct excision with hepaticojejunostomy is performed. Port-site excision is done if previous laparoscopic cholecystectomy was performed.
Recovery
Radical cholecystectomy: 5-7 days hospital stay. Resume normal activities in 3-4 weeks. Adjuvant chemotherapy begins 4-6 weeks post-surgery. Regular follow-up with CT and tumor markers every 3 months for 2 years.
Prevention
- Cholecystectomy for symptomatic gallstones (prevents chronic inflammation)
- Remove gallbladder polyps >10mm
- Treat porcelain gallbladder with cholecystectomy
- Regular ultrasound surveillance for high-risk individuals
Frequently Asked Questions
Can gallbladder cancer be cured?
I had cholecystectomy and cancer was found in the specimen — what now?
Expert Consultation Available
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