Gall Bladder cancer - Dubai General Surgery Clinic

Gallbladder cancer is a rare disease; it usually starts in the inner layer and grows into the outer layers, and almost all gallbladder cancer is of the adenocarcinoma type. Gallbladder cancer is sometimes noticed accidentally during the gallbladder removal for other reasons.

The gallbladder is made up of three main layers of tissue:

• Mucosa: inner layer of tissue which covers the wall of the gallbladder.
• Muscularis: middle layer.
• Serosa: outer layer of the gallbladder wall.

The following risk factors to developing the cancer in gallbladder.

• Gallstones: the most important risk factor in gallbladder cancer.
• Gallbladder polyps: gallbladder removal is recommended for people with gallbladder polyps more than 1cm because these polyps are more likely to be cancerous.
• Family history.
• Age: older than 70.
• Gender:Women.

Gallbladder cancer is hard to detect early for the following reasons:

• No specific signs or symptoms in the early stages.
• In advanced stages, symptoms are similar to the symptoms of many other diseases.
• The gallbladder anatomy: it is hidden under the liver.

Symptoms of gallbladder Cancer:

Typically, gallbladder cancer doesn't show any symptoms until late stage in the disease, when the tumor has grown up and spread.

Gallbladder cancer symptoms include:

• Jaundice: yellow coloring in skin and eyes due to high bilirubin level in blood stream after the blockage of pile duct.
• Nausea.
• Vomiting.
• Abdominal pain: most likely in the upper right quadrant of the belly.
• Itching.
• Weight loss.
• Loss of appetite.
• Abdominal mass.
• Dark urination.
• Light colored stools.

How can diagnose a gallbladder cancer?

Following tests and imaging can give an idea about the gallbladder and nearby organs in both function and structure.also, these investigations are very important to find out the gallbladder cancer staging in order to put a suitable treatment plan.

• Liver function tests LFT: typically includes a specific enzymes, total protein, bilirubin and albumin.
• Ultrasound abdomen US
• CT scan abdomen: for both, diagnosing and staging.
• Percutaneous transhepatic cholangiography PTC
• Endoscopic retrograde cholangiopancreatography ERCP
• MRI abdomen: most likely for staging purposes.
• Endoscopic ultrasound EUS: it is a procedure in which an ultrasound can be done during an endoscopy.
• Laparoscopy: for staging, checking if the tumor is resectable or not, and for taking a sample from tumor (biopsy).

The treatment plan of gallbladder cancer depends on the tumor stage, the symptoms, the patient’s age and the general health.

The following treatment is used in case of gallbladder cancer:

Surgical treatment for Gallbladder Cancer:

Curative treatment: surgery can be a curative gallbladder cancer treatment in early stages by doing cholecystectomy. Also, nearby adjacent lymph nodes may be removed at same procedure.

Palliative treatment: to relieve symptoms such as jaundice, itching and pain in advanced stages.Palliative surgery in gallbladder cancer consists of biliary bypass, stent insertion and percutaneous trans hepatic biliary drainage in case of blocked common bile duct.

Chemotherapy: it uses drugs to stop the growth of tumor cells by killing it or by stopping its dividing.

Radiotherapy: it uses high energy of X-rays on the targeted area of body to kill a tumor cells.

Targeted therapy: it uses drugs which identify and attack only a specific tumor cells.

Immunotherapy: it uses substances which boost and direct the body immune system against the tumor.

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