What to do if after your gall bladder surgery, your surgeon tells you that your gall bladder pathology has shown cancer??

What to do if after your gall bladder surgery, your surgeon tells you that your gall bladder pathology has shown cancer??

Many a times it happens that after your gall bladder surgery done for simple gall stones and when pathological reports comes, You are shocked to hear that actually you had gall bladder cancer.

What to do in such a situation?? Does a repeat surgery is required??  If yes when??

Is there any another way to manage?? How to follow up ???

Cancer of the gallbladder is the most common biliary malignancy, and it is the fifth most common gastrointestinal cancer. it is usually diagnosed at an advanced stage, resulting in an overall median survival of less than 6 months. However, advances in our understanding of its tumor biology accompanied by progress in diagnostic and surgical extirpative techniques have motivated a fresh, new approach to this once universally fatal disease; indeed, the possibility of cure is a real one for a subset of patients presenting with gallbladder cancer.

Surgery:

Gallbladder cancer is unfortunately highly resistant to chemotherapy, and its proclivity toward diffuse peritoneal spread limits the applicability of radiation therapy. Surgery is the only treatment for cure in case of gall bladder carcinoma. The standard template on which all operations for gallbladder cancer should be based is the so-called radical or extended cholecystectomy. which include gall bladder removal along with part of liver removal.

However sometime cancer is detected only in pathological examination after removal of gall bladder for gall stone diseases. This is known as incidental gall bladder cancer.

In this type of cancer need for further surgery or removal of part of liver or gall bladder bed is some time required for cure otherwise tumor might recur at any time.

Decision regarding this generally depends on pathological spread of cancer in the gall bladder wall.

It is divided in to 4 stages, as shown in figure. Here T1a means tumor limited in inside wall of gall bladder.

Generally no further treatment is required if cancer is of T1a stage that is limited to gall bladder inside wall.

For anything greater than T1a further surgery and removal of part of liver and lymphatic tissue are required to improve cure rates.