Synonyms in a broader sense
Gall bladder tumor, gall bladder carcinoma, squamous cell carcinoma, adenocarcinoma, porcelain gall bladder
Therapy
The therapy of gallbladder carcinoma is very difficult, since most gallbladder carcinomas are diagnosed in an incurable (non-curative) stage. However, healing is only possible through an operation in which the entire tumor has been removed, including the affected lymph nodes. However, in the advanced stage, surgery is also useful because it restores the drainage conditions and thus improves the quality of life. If the tumor is too advanced and surgery is no longer possible, palliative therapy is indicated. This means that a curative approach is no longer possible and that the aim of the therapy is to alleviate the symptoms caused by the tumor.
Operative procedure
In addition to the gall bladder (cholecystectomy), it is not uncommon for part of the liver (partial resection of the liver) to be removed as well, since the tumor has often already grown into it. It is important to restore a smooth bile flow during the operation. In rare cases, after a cholecystectomy that has been removed for other reasons, such as gallstone disease, an early-stage carcinoma is discovered by the pathologist. Sometimes a re-operation is necessary, for example to resect additional lymph nodes (lymphadenectomy). However, these discoveries remain rather an exception.
Pathological diagnostics
After removal, the gallbladder tumor is assessed by the pathologist on a histological basis. For this purpose, the tumor preparation is incised at specific sites and at the edges of the resection. Wafer-thin slices are made from these samples, stained and evaluated under the microscope.
The type of tumor is determined, its spread in the gallbladder wall is assessed and the removed lymph nodes are examined for tumor infestation. It is also important that the edge of the tumor is sufficiently distant from the healthy tissue so that there should be no tumor cells at the edge of the incision that could later cause the tumor to grow back (recurrence). Only after the pathological findings, the tumor can be clearly classified according to the TNM classification, which describes the primary tumor (T), the lymph nodes (N) and the distant metastases (M).
