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Surgery that aims to cure your cancer

Surgery is the main treatment for gallbladder cancer. There are many possible types of operations to remove the cancer.

The amount of surgery you need will depend on the stage of your gallbladder cancer. Your surgeon may suggest surgery to remove the cancer and try to cure it or relieve symptoms (palliative surgery).

There are a number of possible operations that can be used to remove the cancer (and gallbladder). Some of them are extremely major surgery. The type of operation you have depends on where the cancer is in the gallbladder and how far it has spread outside your gallbladder.

Removal of the gallbladder (simple cholecystectomy)

You have your whole gallbladder removed in this operation, and nothing else.

Usually the upper right side of your tummy (abdomen) is opened up to have a simple cholecystectomy. But some people can now have this operation with a laparoscope - a long fibre optic tube with a light and an eyepiece that the surgeon uses to look inside the body. This is also called keyhole surgery or laparoscopic cholecystectomy.

You have the operation under general anaesthetic, so you will be asleep throughout. Your surgeon will make 3 or 4 small cuts (called port sites) in your abdomen.

They then put a needle into your abdomen and pump carbon dioxide gas inside. The gas is harmless. It helps to make some space inside your abdomen for the doctor to move the laparoscope around freely and put in any instruments that are needed. While watching the operation down the eyepiece or on a screen, the surgeon will then cut away and remove your gallbladder.

Removal of the gallbladder, lymph nodes and part of the liver (extended or open cholecystectomy)

You have this operation if the cancer has spread throughout your gallbladder. Your surgeon will take out:

  • all of your gallbladder
  • about 2.5cm (1 inch) of liver tissue nearest to the gallbladder
  • all the lymph nodes around your gallbladder
  • tissue surrounding the site of any previous keyhole surgery to the gallbladder

This is to make sure that any cancer cells in the surrounding tissues are removed. In the lab a pathologist will examine all the tissues that the surgeon takes out. They will look for clear margins.

This means that the surgeon has been able to remove all the cancer plus a surrounding border of tissue that is cancer free. Having clear margins helps to lower the risk of the cancer coming back.

Removal of the gallbladder and surrounding tissues (radical resection)

If the cancer has spread outside your gallbladder to nearby lymph nodes, your surgeon will do an even bigger operation. The surgeon will remove:

  • the gallbladder
  • a small part of the liver close to the gallbladder
  • the common bile duct
  • part or all of a fibrous strap (a ligament) that connects your liver and intestines
  • the lymph nodes from around nearby organs such as the liver, stomach, intestines and pancreas
  • tissue surrounding the site of any previous keyhole surgery to the gallbladder

Surgery to remove nearby organs affected by the cancer

If your surgeon thinks the cancer has spread to other organs in your body, you may need to have them removed. This can include taking out:

  • your pancreas
  • your duodenum (the beginning of your small bowel)
  • a larger part of your liver
  • any other parts of organs that contain cancer cells, for example your stomach or part of your bowel

Operations to remove other organs

You may have other organs taken out during your gallbladder operation. These operations can include:

Gastrojejunostomy

In a gastrojejunostomy, your surgeon takes out your gallbladder, bile ducts and duodenum and reconnects your stomach to your small bowel (intestine).

Liver (hepatic) resection

Hepatic resection means taking out part of your liver. Your surgeon may do this if the cancer has spread from your gallbladder to part of your liver. It is only usually possible to do this if the cancer is small and when there are no major blood vessels affected by the cancer.

Hepatic lobectomy

A hepatic lobectomy means removing a lobe of the liver. If you have no medical problems with your liver (such as cirrhosis) it is possible for the liver to grow back and work normally after surgery.

It is important that your liver function is carefully checked before you have surgery. As the liver is such a vital organ, your doctors need to know that the remaining part of your liver can work well enough after your operation. If you have cirrhosis, your liver may not work well enough for your body to cope. Liver failure after surgery is much more likely in people who have cirrhosis.

Hepatopancreatoduodenectomy

Hepatopancreatoduodenectomy means taking out your pancreas, duodenum and some liver tissue.

Pancreatoduodenectomy

Pancreatoduodenectomy is also known as a Whipple’s or Kausch-Whipple's operation. This means removing:

  • part of your pancreas
  • your duodenum (the first part of your small bowel)
  • part of your stomach
  • your gallbladder and part of your bile duct

Large bowel resection

Large bowel resection means taking out part of the large bowel (colon). This will be done if there are signs that the cancer has spread to your large bowel. The affected part of the bowel is cut out and the two ends rejoined.

Last reviewed: 
24 Oct 2017
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