Gallbladder cancer

Question 1

Define gallbladder cancer and which type it is. Risk factors

Answer 1

Malignant tumor mostly adenocarcinoma
RF: porcelain gallbladder, gallstones, choledochal cysts

Question 2

Symptoms and diagnosis of gallbladder cancer

Answer 2

RUQ mass, abdomen pain, N/V, weight loss, jaundice, hepatomegaly

Diagnosis by US, CT, ERCP, MRI

Question 3

Treatment of gallbladder cancer

Answer 3

If confined to mucosa: cholecystectomy.
If reached muscularis and serosa: cholecystectomy with wedge resection of overlying liver border and portal LN dissection. If reached liver then palliative

Question 4

Define choledochal cysts and presentation

Answer 4

Premalignant cystic dilation of intrahepatic or extrahepatic bile ducts. Presents with classic triad: palpable abdomen mass, abdomen pain, jaundice

Question 5

Diagnosis and treatment of choledochal cysts

Answer 5

US,MRI,CT,ERCP

Tx for majority of cases: excision of common bile duct, cholecystectomy, roux en Y hepaticojejunostomy

Question 6

Cholangeocarcinoma define, risk factors, symptoms

Answer 6

Tumor of intrahepatic or extrahepatic ducts, commonly affecting junction of left and right common hepatic ducts.

RF: choledochal cysts, cholelithiasis, PSC, chronic hepatitis

Symptoms: jaundice, pale stool, dark urine, weight loss, abdomen pain

Question 7

Diagnosis and tx of cholangiocarcinoma

Answer 7

Diagnosed by high bilirubin, GGT, ALP

Tumor markers CA19-9 and CEA

US show bile duct dilations. CT

Treatment if proximal: hepaticojejunostomy. If distal: whipple proceduce (pancreaticojejunostomy)