How is gallbladder cancer diagnosed?

Some gallbladder cancers are found after a gallbladder has been removed to treat gallstones or chronic (long-term) gallbladder inflammation. Gallbladders removed for those reasons are always looked at under a microscope by a pathologist (a doctor specializing in diagnosis of disease through lab tests) to see if they contain cancer cells. Most gallbladder cancers, though, are not found until patients go to a doctor because they have symptoms.

Signs and symptoms of gallbladder cancer

Signs and symptoms are usually not present until the later stages of gallbladder cancer, but in some cases they may lead to an early diagnosis. If you go to your doctor when you first notice symptoms, your cancer might be diagnosed at an earlier stage, when treatment may be more effective. Some of the most common symptoms of gallbladder cancer are:

Abdominal pain

When they are first diagnosed, most people with gallbladder cancer have abdominal (stomach area) pain. Most often this is in the upper right part of the abdomen.

Nausea and/or vomiting

Many people with gallbladder cancer report vomiting as a symptom.

Jaundice

Jaundice is a condition that gives a yellowish color to the skin and the white part of the eyes. When bile from the liver can’t drain into the intestines because a cancer is blocking the bile duct, bilirubin, a chemical in bile that gives it a yellow color, may build up in the blood and settle in different parts of the body. This can cause the color changes seen in the skin and eyes. Some patients with gallbladder cancer have jaundice when they are diagnosed.

Gallbladder enlargement

If cancer is blocking the bile duct, bile can also build up in the gallbladder, making it larger than usual. The enlarged gallbladder can sometimes be felt by the doctor during a physical exam. It can also be detected by imaging tests such as ultrasound.

Diagnosis of Gallbladder Cancer

• Physical Examination and History : An examination of the body is done to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual.
• Liver Function Tests : A procedure in which a blood sample is checked to measure the amounts of certain substances released into the blood by the liver.
• Carcinoembryonic Antigen (CEA) Assay : A test that measures the level of CEA in the blood. CEA is released into the bloodstream from both cancer cells and normal cells.
• CT Scan (CAT Scan) : A procedure that makes a series of detailed pictures of areas inside the body, such as the chest, abdomen, and pelvis, taken from different angles.
• Ultrasound Exam : A procedure in which high-energy sound waves (ultrasound) are bounced off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram. An abdominal ultrasound is done to diagnose gallbladder cancer.
• PTC (Percutaneous Transhepatic Cholangiography) : It is a radiologic technique used to visualize the anatomy of the biliary tract. A contrast medium is injected into a bile duct in the liver, after which X-rays are taken. It allows access to the biliary tree in cases where endoscopic retrograde cholangiopancreatography (ERCP) has been unsuccessful.
• ERCP (Endoscopic Retrograde Cholangiopancreatography) : ERCP can be performed for diagnostic and therapeutic reasons. The technique combines the use of endoscopy and fluoroscopy to diagnose and treat certain problems of the liver, gall bladder, pancreas and the common bile and pancreatic duct. Through the endoscope, the physician can see the inside of the stomach and duodenum, and inject radiographic contrast into the ducts in the biliary tree and pancreas so they can be seen on X-rays.
• Biopsy : The removal of cells or tissues so they can be viewed under a microscope by a pathologist to check for signs of cancer.
• Laparoscopy : This is a small operation that allows the doctors to look at the gall bladder, the liver and other internal organs in the area around the gall bladder. It is done under a general anesthesia and means a shorter stay in hospital.

Advanced Robotic Surgery for Gallbladder Cancer

Single-Site da Vinci Surgery is minimally invasive - performed through a single small incision using state-of-the-art technology. This procedure is performed using the da Vinci Surgical System. da Vinci is a state-of-the-art robotic surgical platform that translates your surgeon’s hand movements into smaller, more precise movements of instruments inside your body. da Vinci’s vision system provides your surgeon with 3D-HD visualization allowing for enhanced vision, precision, dexterity and control. During the entire procedure, your surgeon is 100% in control of the da Vinci System.

da Vinci Surgery offers patients the following potential benefits:

• Minimal Scarring.
• Minimal Pain.
• Low Blood Loss.
• Fast Recovery.
• Short Hospital Stay.
• High Patient Satisfaction.