Gall cancer ❤️ Blog of the MN Dobrobut

Gall bladder cancer: causes, symptoms and diagnosis

The development of neoplasia in the gallbladder and ducts occurs in 2-8% of cases from the total number of registered oncological neoplasms.

Risk factors

Among some regularities that increase the risk of the development of pathology, such as:

Gender - statistically, women suffer from the disease twice as often as the male part of the population.
Age - in 70% of cases, cancer of the gallbladder and biliary tract occurs in older people.
Presence of stones in the gall bladder. It is believed that stones larger than 3 cm increase the risk of cancer by 10 times, and calcification of the gallbladder wall (the so-called "porcelain" bladder) increases the risk by 10-60%.
Benign neoplasias. Inflammatory and cholesterol polyps provoke the risk of developing oncological pathology.
Primary sclerosing cholangitis, which occurs in 13% of patients, is accompanied by cancer.
Chronic cholecystitis. Against the background of this pathology, the risk of development is seriously increased.
Anomalies of intrauterine growth and development of bile ducts.
Nonspecific ulcerative colitis.
Occupational hazards - the development of tumors is observed in people who work in the production of paper, rubber, in the shoe and textile industries.

Various types of gallbladder cancer

Gall bladder cancer is macroscopically divided into several forms.

Diffuse-infiltrative type of tumor. It is characterized by the growth of the oncological process in the thickness of the wall of the bladder over its entire area, it becomes thick, tuberous.
The nodular type is a malignant node that grows inside or outside the lumen of the bladder, the occurrence is rarely observed.
Papillary variety. It has the form of papillae growing into the lumen of the organ, which is also rare.

Bile duct neoplasias are macroscopically divided into two forms:

Exophytic - grow towards the surface of the ducts.
Endophytic - spread to the lumen of the organ.

Gall bladder and duct tumors metastasize by two methods:

The lymphatic system, from where malignant cells can enter the lymph nodes surrounding the pancreas and the abdominal aorta.
Blood vessels, from where the process spreads to the liver, peritoneum, lungs, pleura.

Stages of development of gallbladder cancer

Malignant pathological conditions of the gallbladder are divided into several stages:

Stage 1 is manifested by the growth of the tumor process only in the mucous membrane of the bladder wall.
The 2nd degree is distinguished by the occurrence of the process throughout the wall thickness, up to the perforation of its outer layer and germination in the liver or any other organ that surrounds it.
3rd stage is characterized by the penetration of the tumor into any two adjacent organs.
Grade 4 gallbladder cancer is diagnosed when metastases are detected in distant organs.

Gall bladder cancer: symptoms

The tumor process has no special signs and is difficult to diagnose clinically.

skin and mucous membranes of a jaundiced hue;
itching of the skin;
pain in the right hypochondrium,
dark urine and colorless feces;
palpately (to the touch) enlarged biliary or lumpy, slow-moving neoplasm in the abdominal area;
inflammation of the bile ducts;
increase in the size of the liver;
symptoms of intoxication: fever, malaise, muscle weakness, exhaustion.

Clinical types of gallbladder cancer are also distinguished:

Jaundice is characterized by a gradual increase in symptoms that begin with intoxication and continue with the appearance of jaundice with mild pains in the right subcostal area, which progress over time.
The tumor form is manifested by a gradually increasing pain syndrome in the projection of the gallbladder in combination with general oncological symptoms (weight loss, appetite).
The dyspeptic type is characterized by aching pains in the epigastric region of the abdomen, bloating, flatulence and pronounced symptoms of cancer cachexia (exhaustion).
With the septic variety, oncology of the gallbladder is complicated by purulent pathological conditions (cholangitis, abscesses).
With the "silent" form of the disease, the manifestation of symptoms in organs affected by metastases is characteristic, while the main tumor does not make itself known.

Gall bladder oncology diagnosis

Laboratory studies include several important analyses:

General blood analysis - in advanced forms, a decrease in hemoglobin and red blood cells is determined, and in concomitant purulent diseases - an increase in leukocytes, the rate of sedimentation of red blood cells.
General analysis of urine — in the presence of jaundice, it is possible to determine a high level of bile pigments and the absence of urobilin.
Stool analysis - with mechanical jaundice, stercobilin will not be determined.
Biochemical examination of the blood — increased indicators of liver enzymes, bilirubin level, etc.
Determining the presence of tumor markers.

Research by instrumental methods includes:

Ultrasound is the primary method that determines abnormalities in 98% of patients, it is the main method at the initial stage of diagnosing gall bladder oncology due to its simplicity and informativeness. Ultrasound is very difficult to distinguish a tumor of the gallbladder from other pathological conditions.
Study of the oncological process with the help of a computer tomography allows to very clearly visualize the neoplasia and the places of its spread, to describe the degree of damage to the structures surrounding it.
An examination with a magnetic resonance device will complement and improve informativeness.
Endoscopic retrograde cholangiopancreatography is required for a visual examination of the condition of the upper part of the digestive tract and bile ducts. In some cases, it allows to take a biopsy for further research.
Puncture biopsy - with the help of ultrasound, a section of the tumor is taken with a special needle for histological manipulations.
Laparoscopy allows you to visually assess the state of the organs of the abdominal cavity, determine the operability of the tumor, and take a section for histological verification.

Gall bladder cancer treatment

Treatment of oncology of the gallbladder and ducts is carried out with the help of surgical operations and chemotherapy.

Complete treatment of gallbladder cancer can be achieved only in the initial stages of neoplasia.

Cholecystectomy is the usual removal of the gallbladder, which can be done by a classical or laparoscopic method.
Extended operations — used in the early stages of operable tumors and the absence of metastases.

In advanced cases, palliative and symptomatic surgical interventions are used. They do not cure oncology, but they can prolong and improve the quality of life.

Cytoreductive cholecystectomy — removal of the maximum possible volume of neoplasm.
Cholecystostomy or percutaneous cholangiostomy is a connection between the gallbladder/duct and the environment to drain bile and eliminate mechanical jaundice.
Stenting — installation of a stent in the lumen of the bile duct to improve the outflow of bile.
Biliodigestive anastomosis is the creation of a new confluence between the bile ducts and the gastrointestinal tract.
Endoscopic papillosphincterotomy — dissection of the papilla of the bile duct of the duodenum.
Nasobiliary drainage — endoscopic placement of a catheter during retrograde cholangiography and removal of the free end through the nose.

When diagnosed with gallbladder cancer, the prognosis will be favorable only in the initial stages of the disease, over time, the chances of a complete treatment decrease significantly.

Gall bladder cancer prevention

Oncology cannot be completely prevented, but the risk of development can be minimized by taking into account some points.

Promptly treat cholecystitis and gallstone disease, if necessary, perform a cholecystectomy.
Operative treatment will help to reduce the risk of developing a neoplasm with polyposis of the gallbladder.
Mandatory observation by a specialized doctor (especially in the presence of the diseases listed above) with an ultrasound examination of the abdominal organs.
Decreasing the impact of carcinogenic substances on the body will help reduce the risk of developing cancer.

When relevant symptoms appear, it is necessary to urgently visit a specialist for a timely diagnosis of the pathology and to determine the order of further actions.