Updated : January 20, 2024 8:54 AM IST
The gallbladder should be sent to the pathology laboratory for biopsy/histopathology, even if it looks normal. The chance of cancer in a patient with gallstones is less than 1%. However, around 90% of patients with gallbladder cancer have gallstones, which is the most common cause of gallbladder cancer.
If the biopsy report reveals cancer or is suspicious of cancer, it is essential to consult a surgical oncologist. They will review the histopathology report to understand the tumour penetration amount better. In addition, a PET scan should be done to assess the tumour spread in the body. A tumour marker (Ca 19-9) is also helpful.
If the stage is very early stage 1 (pT1a), no further treatment is required, and regular follow-up is enough. If the tumour is late stage 1, stage 2, or early stage 3, a revision radical surgery should be done since there is a high chance of residual disease.
This entails the removal of part of the liver, surrounding lymph nodes, and sometimes other adjacent organs which are affected by the cancer. This should be done even if the PET scan is normal. If late stage 3 or stage 4, only chemotherapy or chemoradiation is an option, and treatment intent is palliative.
An oncologist’s opinion is mandatory if cancer is detected on the biopsy report after cholecystectomy, and, more often than not, further treatment is required.