BILIARY ONCOLOGY · CONDITION GUIDE
Gall Bladder Cancer
A rare but aggressive malignancy of the gallbladder often discovered incidentally after cholecystectomy — requiring radical oncological resection for cure in resectable cases.
ABOUT THIS CONDITION
What is Gall Bladder Cancer?
Gallbladder cancer is a relatively rare but aggressive biliary malignancy with a poor prognosis when diagnosed at an advanced stage. It is often discovered incidentally on histology following cholecystectomy for presumed benign disease. Risk factors include large gallstones, gallbladder polyps, primary sclerosing cholangitis, and porcelain gallbladder. Early-stage cancers confined to the gallbladder wall may be cured by cholecystectomy alone; more advanced disease requires radical re-resection. Dr. Tagore Mohan Grandhi performs radical cholecystectomy for gallbladder cancer at Lux Hospitals, Hyderabad, as part of a multidisciplinary hepatobiliary oncology team. Radical resection includes excision of the hepatic bed, regional lymphadenectomy, bile duct excision where involved, and port site excision if laparoscopic surgery was performed before the diagnosis was known.
SIGNS TO WATCH
Common Symptoms
Symptoms that need attention
WHY IT HAPPENS
Causes & Risk Factors
- Large gallstones (>3 cm) causing chronic gallbladder wall inflammation
- Gallbladder polyps — particularly adenomatous polyps over 10 mm
- Primary sclerosing cholangitis — significantly elevated risk
- Porcelain gallbladder from chronic calcification
- Anomalous pancreaticobiliary junction — a congenital anomaly
- Female sex, obesity, and chronic Salmonella infection as risk factors
CLINICAL DETAILS
KeyFacts
Often incidental on cholecystectomy histology
Radical re-resection of hepatic bed with lymphadenectomy
Hepatic bed excision, lymphadenectomy, port site excision
Over 90% for T1a; under 30% for T3/T4 disease
Gemcitabine-based chemotherapy for advanced stages
Available at Lux Hospitals, Hitech City, Hyderabad
HOW WE TREAT IT
Treatment Approach
Radical Cholecystectomy with Hepatic Bed Excision
For gallbladder cancer staged T1b or above, simple cholecystectomy is insufficient. Dr. Grandhi performs radical re-resection including excision of the hepatic bed (segments IVb and V), regional lymphadenectomy of the hepatoduodenal ligament, and port site excision when prior laparoscopic surgery was performed before diagnosis — offering the best prospect of cure for resectable disease.
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Staging & MDT Assessment
CT thorax, abdomen, and pelvis stages the tumour. MRI liver and MRCP assess hepatic involvement and biliary anatomy. PET-CT may be used to exclude metastatic disease before radical resection.
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Re-staging After Incidental Discovery
Histology from the cholecystectomy specimen is reviewed for depth of invasion (T stage), margin status, and vascular or perineural invasion. MDT determines whether radical re-resection is indicated.
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Radical Cholecystectomy & Lymphadenectomy
Hepatic bed excision (segments IVb and V), regional lymphadenectomy of the hepatoduodenal ligament, bile duct excision if involved, and port site excision are performed as a combined procedure.
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Post-operative Oncology
Adjuvant chemotherapy is initiated following adequate surgical recovery. Surveillance CT and tumour markers are monitored at regular intervals. MDT review is ongoing throughout the oncological pathway.
AVAILABLE TREATMENTS
TreatmentOptions
Laparoscopic Cholecystectomy
The gallbladder is surgically removed — the definitive treatment for symptomatic gallstones and recurrent gallbladder attacks.
Chemotherapy
Drug therapy is used to control disease, reduce recurrence, or treat advanced gallbladder cancer.
Radiation Therapy
Targeted radiation may be used to control cancer locally or as part of combined treatment.
COMMON QUESTIONS
Frequently Asked Questions
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