Gallbladder Cancer — Overview

Gallbladder cancer is the most common biliary tract cancer in India, particularly in the Gangetic plains. It is often discovered incidentally after laparoscopic cholecystectomy for gallstones. Gallstones, porcelain gallbladder, large polyps (>10 mm) and anomalous pancreaticobiliary junction are risk factors.

Staging & Surgery

• T1a — limited to mucosa; simple cholecystectomy is curative
• T1b / T2 — involves muscle or perimuscular tissue; requires extended (radical) cholecystectomy with resection of liver segments IVb and V (2 cm margin) and regional lymphadenectomy
• T3 — extends to liver, stomach, bile duct; requires hepatic resection, common bile duct excision with biliary reconstruction, and extended lymph node dissection
• T4 / metastatic — generally not resectable; palliative chemotherapy

Port Site Recurrence After Laparoscopic Cholecystectomy

If gallbladder cancer is diagnosed incidentally after laparoscopic cholecystectomy, the trocar port sites must be excised at re-operation to prevent port site recurrence. Re-exploration should be done within 4–6 weeks of the initial surgery. Dr. Ashok Kumar advises all patients with incidentally discovered gallbladder cancer to undergo formal staging and re-operation planning at Charak Hospital.