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Further tests for gallbladder cancer

Men and women discussing gallbladder cancer

This page is about what happens when you have further tests after being diagnosed with gallbladder cancer.

 

A quick guide to what's on this page

Further tests for gallbladder cancer

If tests show you have gallbladder cancer, your specialist will ask you to have further tests to see if the cancer has spread. You may have

For most of these tests, you will need to visit the outpatients department. You will  need to stay in hospital overnight for a laparoscopy, which you have under general anaesthetic.

After the tests

You will be asked to come back to the hospital when your test results have come through. This is bound to take a little time, even if only a week or so. You are likely to feel anxious during this time. While you are waiting for results it may help to talk to a close friend or relative about how you are feeling. Or you may want to contact a cancer support group to talk to someone who has been through a similar experience.

 

CR PDF Icon You can view and print the quick guides for all the pages in the diagnosing gallbladder cancer section.

 

Why you need more tests

If your tests show you have gallbladder cancer you may need further tests to see if the cancer has spread. These tests help your doctor to decide on the treatment you need.

The most common area for gallbladder cancer to spread to is the liver, because it is so close to the gallbladder. The cancer spreads to the liver in about 8 out of 10 people (80%). It can also spread to the lymph nodes in your tummy (abdomen). Tissue fluid from body organs drains into lymph vessels and passes through the lymph nodes as it circulates around the body on its way back to the bloodstream. If any cancer cells have broken away, they can travel to the nearby lymph nodes in tissue fluid.

You may be asked to have one or more of the tests listed on this page.

 

MRI scan

An MRI scan uses magnetism to build up a picture of the body. Soft tissue shows up more clearly on this scan than on a CT scan.

You can't usually have an MRI scan if you have metal inside your body (for example, a pacemaker). MRI used with cholangiography can be better than some other tests at showing whether a cancer is blocking the flow of bile. It can also show whether the cancer has grown around the portal vein (the vein bringing blood to the liver from the stomach and intestines). Your doctor may call this MR angiography. MRI can also help to show whether a tumour is only in the gallbladder, or if it has also spread to the liver.

There is more information about having an MRI scan in the section about cancer tests.

 

Endoscopic ultrasound

An endoscopic ultrasound uses an endoscope and an ultrasound scanner. It is much the same as having an endoscopy. But an ultrasound probe is attached to the endoscope tube. This test can help doctors to work out the stage of cancer. It also helps to show if the cancer has grown into the wall of the gallbladder or spread to the liver. This helps to plan for surgery.

 

Cholangiography

Cholangiography means looking at the bile ducts with dye and X-rays. Dye (contrast medium) inside the biliary tract helps to show it up more clearly on X-ray. This is done while you are having an endoscopy. An endoscope is a tube with a camera and a light that a doctor uses to look inside your body. In this case, the endoscopy tube goes into your mouth and down into your stomach and duodenum. The doctor can see where the dye is going on a screen. The nurse or doctor injecting the dye will ask you to hold your breath and then as you breathe out they inject the dye. You may get a feeling of pressure or fullness in the upper right side of your back. This will be uncomfortable but only lasts for a short while. Your hands and feet may feel numb during the procedure, which usually takes about 30 to 60 minutes.

The dye gives a very clear picture on an X-ray. Your doctor should be able to see if there is a tumour in the gallbladder, or if your bile duct is blocked. If it is, your doctor will put in a small tube called a stent to allow bile to drain out of the body into a drainage bag. This will relieve any jaundice symptoms you have. It also stops bile leaking out of the swollen gallbladder and causing a serious infection. You'll then have to stay in hospital until you can have an operation to put an internal stent in. This is a tube that goes inside the bile duct and allows bile to drain into your intestine, as it normally would. There is more about stents in this section.

If there is no blockage, you will stay in bed resting for about 4 hours. Your doctor will ask you to lie on the side that was injected because this helps to stop bleeding and bile leakage. Then you will be able to go home.

If you get a high temperature (over 38.5 degrees C) or have pain that won't go away, you may have a bile leak or an infection and you should get back in touch with the hospital. Normally, before you leave the hospital, you are given a phone number to ring in case you have any problems.

 

Laparoscopy

A laparoscopy is a small operation. A laparoscope is a tube with a camera and a light. Your doctor makes small cuts (incisions) in your tummy (abdomen) and pushes the tube inside. They can look inside for signs of cancer. The laparoscope allows the surgeon to look directly at your gallbladder. Laparoscopy can help to plan surgery or other treatments for you.

You have this test under general anaesthetic, so you will have to stay in hospital overnight. Afterwards, you will have one or more small wounds, with a couple of stitches in each.

During a laparoscopy, your doctor can take small bits of tissue (biopsies) to examine for cancer cells. If you have a cancer, the biopsies may show the exact type you have. Biopsies may also help to show how far your cancer has grown (the stage).

If you have gallstones or an inflamed gallbladder, your surgeon may remove your gallbladder during a laparoscopy. An operation to remove the gallbladder is called a cholecystectomy (pronounced coal-ee-sis-teck-tom-ee). So this is a laparoscopic cholecystectomy. An advantage of laparascopic surgery is that you are likely to recover much more quickly than from normal gallbladder surgery. There is more about laparoscopic cholecystectomy in the section about surgery for gallbladder cancer.

 

After your tests

You will be asked to come back to the hospital when your test results have come through. This is bound to take a little time, even if only a week or so. You are likely to feel anxious during this time.

While you are waiting for results it may help to talk to a close friend or relative about how you are feeling. Or you may want to contact a cancer support group to talk to someone who has been through a similar experience. Look at the gallbladder cancer organisations page to find people who can give you information about support groups. You can look at the counselling organisations page to find details of counselling services near you.

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Updated: 30 August 2012