Gallbladder Carcinoma

• Gallbladder (GB) carcinoma is 5th most common malignancy of the gastrointestinal tract and its incidence varies widely worldwide. Long-term survival can only be achieved with complete surgical resection, which is guided by the T stage.

• In early GB cancer T1a tumors can be treated with a simple cholecystectomy while T1b or T2 tumors demand an extended cholecystectomy (associated or not with bile duct resection). Advanced GB cancer (T3 or T4) usually requires extended major hepatectomy and common bile duct resection and reconstruction.Associated regional lymphadenectomy has potential therapeutic and prognostic benefits.

• Radical surgery has no proven benefit in metastatic disease (including lymphnodes outside the hepatoduodenal ligament).

• The high rate of recurrence after curative resection of GB carcinoma justifies the use of adjuvant therapy (except for T1 disease), despite the scarcity of data.

• The majority of patients with GB carcinomas present with advanced disease and palliative treatment of symptomatic jaundice, pain, or gastrointestinal obstruction is frequently required.