Surgical Management of Gallbladder Carcinoma

Abstract

Gallbladder carcinoma is the commonest malignancy of the hepatobiliary system. It is plagued by the dismal outcome in terms of 5-year survival and high recurrence rate. The varying presentation from an incidental surprise during routine laparoscopic cholecystectomy for gallstone disease to presentation in advance stage. Surgical resection remains the only curative alternative; however, it is only possible in few patients at the time of diagnosis. Although, radical cholecystectomy is said to be the standard of surgical care, yet the extent of liver resection, lymphadenectomy, bile duct resection, adjacent organ resection, and palliative surgical treatment needs to be elaborately discussed. The resection of tumor with R0 margin with appropriate lymphadenectomy is the only hope for long-term survival. Revision surgery should be considered in patients who underwent simple cholecystectomy with incidentally diagnosed gallbladder carcinoma that invaded muscularis propria or beyond. The advance lesions are treated non-operatively with palliative intension. This review discusses the current surgical treatment options in patients with gallbladder cancer depending on the stage of disease.