Gall bladder Cancer

The most common symptom of Gallbladder Cancer is right upper abdomen pain with loss of appetite and weight loss, other symptoms include jaundice/vomiting; USG abdomen show irregular GB wall thickening/GB mass; Whenever there is doubt of Gallbladder Cancer on USG; don't do FNAC; CECT abdomen is done which will give more idea about the mass/thickening, local and distant spread; MRCP is indicated in patients who present with jaundice; Upper GI Endoscopy is done when there is suspicious of involvement of duodenum Surgery is the preferred mode of treatment for Gallbladder Cancer if the patient is fit for surgery, role of chemo or radiotherapy is less; First Staging Laparoscopy is done and if no distant metastases is detected in staging laparoscopy then right subcostal incision is given, first inter aorto-caval lymph node sampling is done and if negative for malignancy then radical cholecystectomy with lymphadenectomy is performed in which segment IV B and V of liver is resected; Intra-op cystic duct margin is sent for frozen section if it is positive then CBD exicision with Roux-en-Y Hepatico-jejunostomy is done.