Treatment of Gallbladder Cancer

Early detection, early diagnosis, and timely radical surgical resection are the only treatment principles for gallbladder cancer.

1. Surgical treatment

1. Simple cholecystectomy: If the cancer is limited to the mucosal layer or submucosal layer, simple cholecystectomy can achieve the purpose of radical cure. This situation is often seen in patients with gallbladder stones or gallbladder sarcoid lesions who have gallbladder cancer after cholecystectomy.

2. Cholecystectomy plus regional lymph node dissection: The tumor invades the muscular layer or the entire layer of the gallbladder, and the gallbladder has lymph node metastasis. The gallbladder is removed, and the lymph nodes within the hepatoduodenal ligament, the lymph nodes behind the pancreatic head, and the eighth group of lymph nodes are removed.

3. Combined partial hepatectomy L Gallbladder body cancer with liver infiltration is combined with partial hepatectomy and lymph node removal. If adjacent organs (such as transverse colon or duodenum) are infiltrated, the resection range should be expanded.

4. Combined extrahepatic bile duct resection: For cancer of the gallbladder neck or gallbladder duct, involvement of the extrahepatic bile duct with obstructive jaundice, cholecystectomy is performed, and the affected bile duct is removed, lymph nodes are cleared, and hilar bile duct Roux-en-y jejunostomy is performed.

2. Chemotherapy

Studies on chemotherapy for gallbladder cancer that has lost the opportunity for surgery or has metastasized are not reliable because of the small number of cases or the inclusion of hilar cholangiocarcinoma. Commonly used chemotherapy drugs are fluorouracil, mitomycin, cisplatin, and doxorubicin. Since most patients have relatively localized lesions, research on regional chemotherapy for gallbladder cancer has now become more important.

(III) Radiotherapy

For gallbladder cancer that cannot be surgically removed, the blocked extrahepatic bile duct can be reopened in some cases after external radiotherapy.

4. Comprehensive treatment

Even after resection, most patients with gallbladder cancer die due to tumor recurrence or metastasis. Non-randomized studies and case reports have shown that patients in stages II, III, and IV can improve their survival through adjuvant radiotherapy and/or chemotherapy.