Gall bladder cancer: a review

Abstract

Introduction: Gall bladder cancer is the most aggressive cancer and the commonest malignant tumor of the biliary tract worldwide.The incidence increases with age and women are more commonly affected. Surgical resection is the only chance for complete cure,however only 10% of patients are candidates for curative surgery at initial presentation.

Objective: To review the current concepts and key issues in the diagnosis and management of gallbladder cancer.

Methodology: A systematic review of published literature was done using search Google Search Engine, Highwire press and Springer Link selected papers were taken and books from author's collection used for further reference.

Results: The risk factors of gallbladder cancer include race (like India), cholelithiasis,polyps, pancreatico-biliary maljunction anomalies, chronic inflammation, exposures to heavy metals and chemicals and infections (e.g. liver flukes). It may present as mass lesion, localized wall thickening or polypoid growth. Adenocarcinoma is the commonest histological type.The clinical presentation is divided into 5 syndromes namely acute cholecystitis, chronic cholecystitis, biliary tract disease, non specific symptomatology and symptoms related to metastatic disease.Complete surgical treatment is the only curative treatment for gallbladder cancer but only a few cases are seen at this curative stage.

Conclusion: Gallbladder cancer is relatively uncommon with high mortality rate. Risk factors include advance age, female gender, cholelithiasis, porcelain gallbladder, gallbladder polyps, congenital biliary cysts, chronic infection and smoking.Most are discovered incidentally at routine cholecystectomy or present at advance stage of the disease. Surgery is the only curative therapy for gallbladder cancer and the extent is dependent on the TNM stage. However, at diagnosis, only 10% of patients are candidates for curative surgery.

Keywords: Gallbladder, Cancer