Surgical Treatment for Gallbladder Cancer: A Comprehensive Guide and Further Insights
Gallbladder cancer surgery is a critical treatment option for individuals diagnosed with the disease. The choice of surgical procedure depends on several factors, including the stage and spread of the cancer, a person's overall health, and the surgeon's expertise.
Surgical Procedures for Gallbladder Cancer
- Simple Cholecystectomy - This procedure involves the removal of the gallbladder alone, often performed laparoscopically for very early-stage cancers like Tis (carcinoma in situ) and T1a tumors. Benefits include smaller incisions, less blood loss, shorter hospital stays, and faster recovery.
- Extended or Radical Cholecystectomy - This surgery involves the removal of the gallbladder plus a wedge resection of adjacent liver tissue or formal resection of liver segments IVb and V. Regional lymphadenectomy is also performed to ensure complete cancer removal. This procedure is typically recommended for T1b and T2 gallbladder cancers where there is a higher risk of spread beyond the gallbladder.
- Minimally Invasive Surgery (Laparoscopic or Robotic-Assisted) - Increasingly applied for early-stage gallbladder cancer, this method offers advantages such as reduced blood loss, faster recovery, and shorter hospital stays compared to open surgery. However, it requires high surgical expertise to achieve cancer clearance and avoid complications.
- Open Surgery - Reserved for complicated cases, advanced tumors, severe inflammation, or when minimally invasive surgery is contraindicated, open surgery involves a larger incision and may involve extensive liver resection and lymphadenectomy.
Advanced procedures such as direct chemotherapy application within the abdomen (HIPEC or PIPAC) may be used adjunctively or in advanced cases, but these are not primary surgeries for tumor removal.
Post-Surgery Care and Risks
After gallbladder cancer surgery, individuals have regular follow-up checks to monitor for the return of cancer and complications. Complications may include bile leaking into the abdomen, infections, liver failure, blood clots, and damage to the ducts that carry bile from the liver.
In a 2016 study, scientists found that the disease returned in 20% of cases after gallbladder cancer surgery, with the median time for the cancer to return during these cases being 9.5 months.
Unresectable Surgery and Other Treatments
Unresectable surgery is performed when the cancer is too advanced or has spread. In such cases, doctors may use other treatments such as radiation therapy, chemotherapy, targeted therapy drugs, and immunotherapy to stop the cancer from returning or control symptoms.
Preparation and Eligibility for Surgery
Preparation for gallbladder cancer surgery includes meeting with doctors, undergoing tests and checks, and receiving advice on reducing the risk of post-surgery complications. People have surgery for gallbladder cancer when doctors believe it will treat or cure their cancer, and they are healthy enough for the procedure.
Recovery time for gallbladder cancer surgery varies and depends on side effects and the extent of the cancer. Surgery is the primary treatment for gallbladder cancer, offering the best likelihood of curing it.
References:
[1] National Cancer Institute. (2021). Gallbladder Cancer Treatment (PDQ®)–Health Professional Version. Retrieved from https://www.cancer.gov/types/gallbladder/hp/gallbladder-treatment-pdq
[2] National Comprehensive Cancer Network. (2021). Gallbladder Cancer. Retrieved from https://www.nccn.org/patients/guidelines/gallbladder/index.html
[3] American Cancer Society. (2021). Gallbladder Cancer. Retrieved from https://www.cancer.org/cancer/gallbladder-cancer.html
- Surgical options for health-and-wellness in individuals diagnosed with gallbladder cancer may include digestive procedures such as extended or radical cholecystectomy, which involve the removal of the gallbladder plus a wedge resection of adjacent liver tissue, regional lymphadenectomy, and minimally invasive surgery (laparoscopic or robotic-assisted).
- Medical-conditions like bile duct cancer can pose significant complications post-surgery, necessitating close monitoring for the return of cancer and potential issues such as bile leakages, infections, and ducts damage.
- In cases where the cancer is too advanced or has spread, science advances in oncology have made available alternative treatment options, including radiation therapy, chemotherapy, targeted therapy drugs, immunotherapy, or unresectable surgery, which aims to stop the cancer from returning or control symptoms.
