Gallbladder Cancer

Gallbladder cancer is cancer that starts in your gallbladder—a pear-shaped organ below the liver in the upper right abdomen. The gallbladder concentrates and stores bile, fluid made in the liver that helps digest the fats in foods as they pass through the small intestine.

According to the American Cancer Society, approximately 10,500 people in the United States are diagnosed with gallbladder cancer each year. Gallbladder cancer develops in the innermost layer of tissue and spreads through the outer layers. Most gallbladder cancers are adenocarcinomas, cancer that starts in cells. Papillary adenocarcinoma is a rarer form that is not as likely to spread and has a better prognosis. Surgery is a common way to treat gallbladder cancer, offering a cure or palliative relief, depending upon how advanced the cancer is.

Surgeons at Brigham and Women’s Hospital (BWH) specialize in hepatobiliary diseases, including gallbladder cancer. As the surgical team for the Pancreas and Biliary Tumor Center at Dana-Farber Brigham Cancer Center, we offer world-class patient care with leading-edge research in the fight against pancreatic cancer, bile duct cancer and gallbladder cancer. Our board certified surgeons are leaders in minimally invasive surgery for gallbladder cancer, performing a large volume of simple, open and radical cholecystectomy operations. Our surgeons pioneered the use of laparoscopic techniques in treating hepatobiliary diseases and are among the first to use robotic and other minimally-invasive technologies in making these procedures safer.

Read frequently asked questions about gallbladder cancer

Gallbladder Cancer Surgeons

Risks Factors for Gallbladder Cancer

Factors that contribute to an increased risk for gallbladder cancer include:

Gallstones
Female
Older than 65
Hispanic of Mexican descent
American Indian
Obesity
Gallbladder polyps
Primary sclerosing cholangitis (PSC)
Choledochal cysts
Bile duct abnormalities
Exposure to chronic typhoid and paratyphoid infection
Exposure to carcinogens
Family history of gallbladder cancer

Learn if you are at risk for gallbladder cancer.

Symptoms of Gallbladder Cancer

Gallbladder cancer often causes symptoms similar to gallstones or gallbladder inflammation. Typical symptoms include:

Pain or discomfort in the right side of the upper abdomen
A sense of fullness after eating even small amounts
Nausea and vomiting
Poor appetite
Loss of weight
Fever
Yellowing of the skin (jaundice) or the white area of the eyes (scleral icterus)
Skin itching

Diagnosis of Gallbladder Cancer

If you are having symptoms of gallbladder cancer, your surgeon will ask about your health history, your family’s history of cancer and risk factors. Diagnostic tests may include:

Computed tomography scan (CT or CAT scan)
Magnetic resonance imaging (MRI)
Endoscopic ultrasound
Laparoscopy to remove tumor for staging
Tumor marker tests
Endoscopic retrograde cholangiopancreatography (ERCP)
Percutaneous transhepatic cholangiography (PTC)
Biopsy
Liver function tests
Tumor marker tests

Learn more about diagnostic tests for gallbladder cancer.

Stages of Gallbladder Cancer

After gallbladder cancer has been diagnosed, tests are performed to determine if cancer cells have spread within the gallbladder or to other parts of the body.

The TNM system, developed by the American Joint Committee on Cancer and the International Union Against Cancer, is a standard system used to stage gallbladder cancer. TNM represents:

T (tumor) refers to the size of the tumor in the gallbladder and whether or not it has invaded nearby organs.
N (node) refers to whether the lymph nodes in the area of the gallbladder have become cancerous.
M (metastasis) refers to whether the cancer has spread to other, distant organs in the body, such as your bones, liver or lungs.

Gallbladder cancer can also be divided into these three categories:

Localized means that all the cancer can be removed by surgery.
Unresectable indicates that all the cancer cannot be removed during an operation, often because it has spread.
Recurrent means the cancer has come back after treatment.

Treatment for Gallbladder Cancer

Surgical Treatment

Depending upon the stage of gallbladder cancer, surgery can provide a cure or offer palliative relief from symptoms. Surgeons at BWH are internationally recognized surgical specialists who are faculty at Harvard Medical School. They have years of experience in gallbladder cancer surgery and have perfected many of the most progressive surgical procedures including:

Cholecystectomy (simple cholecystectomy) removes the gallbladder. If only the gallbladder is removed, the operation may be called simple cholecystectomy. Gallbladder cancers are sometimes found during a cholecystectomy for another reason, such as gallstones. If cancer has spread beyond the gallbladder, more extensive surgery may be advised.Surgical options are:
- Laparoscopic cholecystectomy uses a smaller incision, limiting the view of the area around the gallbladder, so cancer may be missed. It might also lead to the accidental spread of cancer to other body parts.
- Open cholecystectomy removes the gallbladder through a large incision (cut) in the abdominal wall.
Extended (radical) cholecystectomy is a more extensive operation done in most gallbladder cancer cases since it is a type of cancer that can recur. Extended cholecystectomy removes:
- Gallbladder
- Liver tissue next to the gallbladder
- Lymph nodes
The operation may also remove:
- A larger part of the liver, ranging from a wedge-shaped section of the liver close to the gallbladder (wedge resection) to a whole lobe of the liver (hepatic lobectomy)
- Common bile duct
- Part or all of the ligament that runs between the liver and the intestines
- Lymph nodes around the pancreas, around the major blood vessels leading to the liver (the portal vein and hepatic artery), and around the artery that brings blood to most of the small intestine and to the pancreas
- Pancreas
- Duodenum (the first part of the small intestine into which the bile duct drains)
- Any other areas or organs to which cancer has spread

Non-Surgical Treatment

What You Should Expect

You will receive a thorough diagnostic examination to evaluate if you have gallbladder cancer and determine what course of treatment is needed. Careful monitoring and the involvement of an experienced surgeon are important to the successful outcome for patients with gallbladder cancer.

If you are having surgery or a procedure, you will likely be scheduled for a visit to the Weiner Center for Preoperative Evaluation for pre-operative information and tests.

The day of surgery, you will be cared for in the operating room by surgeons, anesthesiologists and nurses who specialize in surgery for patients with gallbladder cancer. After surgery, you will recover in the post-surgical care unit where you will receive comprehensive care by an experienced surgical and nursing staff.

Learn more about your hospital stay and returning home.

Multidisciplinary Care

The Pancreas and Biliary Tumor Center at Dana-Farber Brigham Cancer Center provides advanced multidisciplinary care for patients with gastrointestinal diseases, such as gallbladder cancer. Our treatment team includes surgeons, surgical oncologists, medical and radiation oncologists, radiologists, pathologists, endoscopists, anesthesiologists and gastroenterologists. In addition, patients have full access to BWH’s world-renowned academic medical community with its diverse specialists and state-of-the-art facilities.

Cancer Surgery Appointments and Locations

Contact one of our cancer surgeons in the list at the top of the page to make an appointment.

Cancer Surgery Locations

Resources

Learn more about gallbladder cancer in our health library.

Visit the Kessler Health Education Library in the Bretholtz Center for Patients and Families to access computers and knowledgeable staff.

Visit the Weiner Center for Preoperative Evaluation.