Gallbladder Cancer

  • The duty of the gallbladder is to store the bile fluid produced by the liver. Bile, which usually accumulates in the gallbladder during fasting, is concentrated and stored here. During digestion, the gallbladder contracts and discharges the bile into the intestine, thus allowing the absorption of fatty substances. Malignant tumors originating from the gallbladder are called gallbladder cancer.
  • It is more common in women.
  • In 1% of patients operated on due to gallstones, gallstones are affected. bladder cancer is determined.
  • What are the symptoms of gallbladder cancer?

  • Jaundice
  • Pain in the upper and right side of the abdomen
  • Fever
  • Nausea and vomiting
  • Gas and burping
  • Swelling in the abdomen
  • These symptoms are often seen in advanced cancers and can cause symptoms in the early stages.
  • What methods are used in the diagnosis of gallbladder cancer?

  • Doctor's examination
  • Liver tests: ALT, AST, GGT, bilirubin , alkaline phosphatase
  • CEA
  • CA 19-9
  • Ultrasonography
  • Computed tomography
  • Lung radiography
  • Magnetic resonance cholangio-pancreatography (MRCP): monitoring the condition of the bile ducts
  • Endoscopic retrograde cholangio-pancreatography (ERCP): bile ducts monitoring the condition and placing a stent (umbrella) in the bile duct when necessary
  • Percutaneous transhepatic cholangiography (PTK): imaging the bile ducts by placing a thin needle into the liver and evacuating the bile ducts if necessary
  • Laparoscopy: the tumor can be investigated and a biopsy can be taken.
  • Which types of gallbladder cancer are there?

  • Carcinoma in situ
  • Adenocarcinoma
  • Papillary carcinoma
  • Mucinous carcinoma
  • Clear cell adenocarcinoma
  • Signet ring cell carcinoma
  • Adeno-squamous carcinoma
  • Squamous cell carcinoma
  • Small cell carcinoma
  • Undifferentiated carcinoma
  • Carcinosarcoma
  • How is gallbladder cancer Is it staged?
    Staging is done between stages 1 and 4, stage 1 is at the beginning and Stage 4 means spread tumor. Gallbladder cancers: spread through tissue, blood and lymph system. When it spreads to other organs, it is called metastic tumor.

    T1: the tumor is on the inner surface of the gallbladder.
    T2: the tumor reaches the outer surface of the gallbladder.
    T3: The tumor has spread beyond the outer surface of the gallbladder.
    T2: The tumor has spread to the veins and arteries of the liver.
    N1: the tumor has spread to the regional lymph nodes.

    Stage I: the tumor is located in the inner part of the gallbladder.
    Stage II: the tumor has reached the outer part of the gallbladder.
    Stage III: the tumor has spread to neighboring organs and lymph nodes.
    Stage IV: the tumor has spread to distant organs and lymph nodes. It has spread to the lymph nodes.

    What factors affect the course of gallbladder cancer?

  • Stage of the cancer
  • Whether the cancer was completely removed in surgery
  • First identified tumor or recurrent tumor
  • How are gallbladder cancers treated?
    Gallbladder cancers are treated with surgery, chemotherapy and radiation therapy (radiotherapy).

  • Surgical treatment
    • The gallbladder and surrounding lymph nodes are also removed. Preferably, the surgery is performed by laparoscopy.
    • In case the tumor causes an obstruction in the intestine, a connection (by-pass) is performed between the gallbladder or bile duct and the small intestine.
    • ERCP: If the tumor blocks the bile duct, a stent (umbrella) can be placed in the bile duct with ERCP.
    • PTK: If it is not possible to place a stent with ERCP, a thin needle is inserted into the liver and the bile ducts are opened.
  • Radiotherapy (radiation therapy)
    Radiotherapy can be applied from outside the body (external radiotherapy) or by placing radioactive needles into the abdominal cavity (internal radiotherapy).
  • Chemotherapy
    Chemotherapy can be given systemically through a vein or regionally as chemotherapy by infusion through the hepatic artery. Liver� 70% of the human blood comes from the vein called the portal vein and 30% from the artery called the hepatic artery. However, it is known that tumors are fed from the hepatic artery. It is based on the principle of placing a catheter (wire) in the artery of the liver called the hepatic artery by an interventional radiologist and administering chemotherapy drug directly into the tumor.
  • What should be the approach in gallbladder cancer?

    Gallbladder cancer in the early stage
    The gallbladder and surrounding lymph nodes are surgically removed. Radiotherapy and chemotherapy can be applied after the surgery.
    Gallbladder cancer in the advanced stage
    Applications such as radiation therapy, chemotherapy and endoscopic stenting are performed with or without surgery.

    What is the course of gallbladder cancer?
    Five-year survival rates in gallbladder cancer cases according to stages are as follows.

    • – Stage I: 30-50%
    • – Stage II: 7-9%
    • – Stage III: 3%
    • – Stage IV: 2%

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