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Gallbladder cancer: Wikis

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Gallbladder cancer
Classification and external resources
ICD-10 C23.-C24.
ICD-9 156
MeSH D005706

Gallbladder cancer is a relatively uncommon cancer. It has peculiar geographical distribution being common in central and south America, central and eastern Europe, Japan and northern India; it is also common in certain ethnic groups e.g. Native American Indians and Hispanics.[1] If it is diagnosed early enough, it can be cured by removing the gallbladder, part of liver and lymph nodes. Most often it is found after symptoms such as abdominal pain, jaundice and vomiting occur, and it has spread to other organs such as the liver.

It is a rare cancer that is still being studied and thought to be related to gallstones building up, which also can lead to calcification of the gallbladder, a condition known as Porcelain gallbladder. Porcelain gallbladder is also rare. Some studies indicate that people with porcelain gallbladder have a high risk of developing gallbladder cancer, but other studies question this. The outlook is poor for recovery if the cancer is found after symptoms have started to occur.

Contents

Risk factors

Signs and Symptoms

Early symptoms mimic gallbladder inflammation due to gallstones. Later, the symptoms may be that of biliary and stomach obstruction.

Disease Course

Most tumors are adenocarcinomas, with a small percent being squamous cell carcinomas. The cancer commonly spreads to the liver, bile duct, stomach,and duodenum.

Diagnosis

Incidentally discovered gallbladder cancer (adenocarcinoma) following a cholecystectomy. H&E stain.

Early diagnosis is not generally possible. People at high risk, such as women or Native Americans with gallstones, are evaluated closely. Transabdominal ultrasound, CT scan, endoscopic ultrasound, MRI, and MR cholangio-pancreatography (MRCP) can be used to diagnose.

Treatment

The most common and most effective treatment is surgical removal of the gallbladder (cholecystectomy) with part of liver and lymph node dissection. However, with gallbladder cancer's extremely poor prognosis, most patients will die by one year following the surgery. If surgery is not possible, endoscopic stenting of the biliary tree can reduce jaundice and a stent in stomach may relieve vomiting. Chemotherapy and radiation may also be used with surgery. If gall bladder cancer is diagnosed after cholecystectomy for stone disease (incidental cancer), reoperation to remove part of liver and lymph nodes is required in most cases - this should be done as early as possible as these patients have the best chance of long term survival and even cure.[2]

Additional images

References

  1. ^ Kapoor VK, McMichael AJ. Gall bladder cancer – an Indian disease. National Medical Journal of India 2003; 16: 209-213.
  2. ^ Kapoor VK. Incidental gall bladder cancer. American Journal of Gastroenterology 2001; 96: 627-629.

External links

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