Liver, Pancreas and Bile Duct Program (HPB)
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Gallbladder cancer is an uncommon disease that usually does not produce any symptoms at the early stages. To achieve the best outcomes, it is important to receive care from a specialist team that can provide aggressive surgical management combined with the appropriate radiation and drug therapies.
Gallbladder Cancer Overview
The gallbladder is a small sack like organ that lies under the liver. It is connected to the liver and the small intestine by the biliary tract. The gallbladder’s function is to store bile produced by the liver until the body needs it for digestion.
Only a few thousand cases of gallbladder cancer are diagnosed in the U.S. every year. Tumors typically originate in the inside layer of the gallbladder wall and spread outward. Cancers that spread beyond the gallbladder often metastasize to the liver.
Early gallbladder cancers usually do not produce any symptoms, and most gallbladder tumors are diagnosed after the organ has been removed for some other reason. (Gallbladder surgery should always be followed by a pathological examination of resected tissue.)
Larger tumors can obstruct the flow of bile, leading to the symptom of jaundice. Gallbladder tumors can also cause cholecystitis, inflammation of the gallbladder that can produce severe pain in the upper right abdomen. (However, it is important to keep in mind that the most common cause of cholecystitis is gallstones.)
Gallbladder tumors require coordinated care from several specialties.
If a tumor is small and has not yet spread to further layers of the gallbladder, a cholecystectomy (gallbladder removal)with a limited liver resection and removal of lymph nodes may be performed.
More advanced gallbladder tumors require a portion of the main bile duct to also be removed.
If a tumor is discovered after the gallbladder has been removed for another reason, patients often undergo a second surgery to remove the portion of the liver near the site of the gallbladder.
Following surgery, patients may undergo external beam radiation therapy.
If a gallbladder tumor is so extensive that it cannot be removed surgically, patients may be treated with radiation. Radiation therapy can reduce pain and improve symptoms.
Chemotherapy is a key element of treatment for gallbladder tumors that have not spread beyond the gallbladder. Following surgery, patients may undergo concurrent chemotherapy and external beam radiation therapy.
For inoperable gallbladder cancers, drug therapy is sometimes given concurrently with radiation therapy.
Advanced gallbladder cancers sometimes metastasize to the liver, where they can develop into large tumor masses. Inoperable liver masses can be treated with chemoembolization. During this minimally invasive procedure, an interventional radiologist uses catheter-based tools to deliver chemotherapy drugs directly to the site of the tumor.
Clinical trials offer patients access to new drugs and treatment approaches. For a complete list of clinical investigations currently available at Froedtert & The Medical College of Wisconsin, see our clinical trials page.