Removing the gallbladder with cancer is a very complex surgery that requires a highly experienced surgeon like the ones at the AdventHealth Digestive Institute. Gallbladder cancer is a rare cancer that starts in the gallbladder, a small pear-shaped sac that stores bile produced by the liver until it is needed for digestion. About 9 out of 10 gallbladder cancers are adenocarcinomas, which involve glandular cells. The most common risk factors for gallbladder cancer is the presence of gallstones and a condition called porcelain gallbladder in which the calcium deposits line the gallbladder as a result of inflammation.
Gallbladder Cancer Symptoms
The symptoms of gallbladder cancer are very similar to those of other digestive cancers and conditions. Because gallbladder cancer is so rare, it is more likely that symptoms are related to another gallbladder condition or even a disorder of the liver.
It is important to see your doctor if you experience any of the following symptoms, which could signal gallbladder cancer:
- Abdominal pain, often in the upper right portion of the belly for patients with gallbladder cancer
- A lump in the right side of the belly caused by an enlarged gallbladder
- Vomiting or nausea
- Jaundice, or yellowing of the skin and eyes
Less common symptoms include:
- Dark urine
- Light-colored stools
- Itchiness
- Fever
- Abdominal swelling
- Loss of appetite
- Unintended weight loss
Diagnosis of Gallbladder Cancer
If your doctor believes you could have gallbladder cancer, you will most likely have the following tests:
- Blood testing to see if there might be a problem with your gallbladder or liver
- Imaging tests that could include ultrasound, CT scan, MRI scan or a combination of these
If your imaging tests show a gallbladder tumor, one of two situations will be likely:
- If the suspicious tumor is confined to the gallbladder, your doctor may want to treat it as if it were cancer. If so, you will have a cholecystectomy to remove the gallbladder without first obtaining a biopsy. This is because collecting tumor cells for biopsy could cause tumor cells to break off from your gallbladder and travel to other parts of your body. The minor inconvenience of living without a gallbladder, as many people do, is worth not risking the spread of cancer.
- If the suspicious area is large or has moved outside of the gallbladder, it is likely that surgery will not be able to remove the tumor completely. In this case, often an endoscopic retrograde cholangiopancreatography (ERCP) is used along with fine needle aspiration to image the gallbladder and remove small tissue samples of suspicious areas and collect some of the bile. A pathologist will study these samples under a microscope to see if they are cancerous.
Minimally Invasive Exploratory Surgery
Sometimes a minimally invasive laparoscopic procedure will be done to stage gallbladder cancer. This procedure checks to see where the tumor has spread and if it can be completely removed. This procedure will help a surgeon plan a patient’s treatment.
Discovery of Cancer During a Cholecystectomy
Occasionally, gallbladder cancer is caught during a cholecystectomy – a routine, usually minimally invasive, surgery to remove the gallbladder. If this is the case, the surgeon will convert the surgery to an open one to make sure all of the tumor is removed. The surgeon can also see if cancer has spread and prevent cancer cells from breaking off from the gallbladder and traveling to other parts of the body.
Surgery to Treat Gallbladder Cancer at AdventHealth
Surgery to remove gallbladder cancer is the best chance for cure. If gallbladder cancer is resectable, it means that it is able to be removed by surgery. Because gallbladder cancer is most often caught in its later stages, only some gallbladder tumors can be removed as the first course of treatment.
Gallbladder resection as a way to treat gallbladder cancer is a very complex surgery that requires a highly experienced surgeon. Some surgeons are comfortable with removing only very small tumors. If you have been told that your gallbladder cancer is unresectable (unable to be removed), consider getting a second opinion. AdventHealth Digestive Institute surgeons may be able to completely remove larger and more advanced gallbladder tumors.
Radical Cholecystectomy
While most people with gallbladder conditions need only their gallbladders removed (a simple cholecystectomy), patients with cancer require a more extensive operation. In addition to the gallbladder, all of the lymph nodes in the area will be removed as well as the part of the liver next to the gallbladder. For early-stage gallbladder cancer, our surgeons can perform a radical cholecystectomy as a minimally invasive surgery. This allows patients to have faster recoveries and move on to their next treatment stage sooner.
Depending on how far the cancer has spread, additional organs and ducts may need to be removed as well. In this case, an open radical cholecystectomy procedure may need to be done to account for the complexity of the surgery.
Palliative Surgery
Sometimes surgery is offered as a treatment that can reduce patients’ pain or to make sure their bile ducts stay unblocked. In this case, it is known as palliative surgery. Although palliative surgery will not cure the condition, it can help prolong patients’ lives and make them more comfortable.
