Cholangiocarcinoma treatment in Turkey

How to treat gallbladder cancer according to modern world clinical protocols of 2021

Diagnosis of gallbladder cancer

• Biochemical blood test — to understand the patient’s condition, you need to know the level of direct and indirect bilirubin, this is necessary to assess the severity of the patient,
• General urinalysis — to assess the degree of jaundice,
• Fecal analysis — to determine the level of stercobilin and also to determine the level of jaundice,
• Ultrasound -a method of primary diagnosis, in which you can
  determine the increase in the gallbladder, its deformation, thickening of the wall, the presence of formations in it. As a rule, more complex diagnostic methods are prescribed after ultrasound,
• Computed tomography with intravenous contrast — it is strongly
  recommended to perform tomography of three areas at once — the abdominal cavity, chest and pelvis, in order to get an idea of the presence or absence of metastases in them,
• Magnetic resonance imaging-is prescribed in addition to computed
  tomography, if there is a need to study in detail the structure of the bile ducts or the attachment of the tumor to large vessels,
• Puncture biopsy — in some cases, a tumor biopsy can be taken with a special needle percutaneously under the control of ultrasound,
  Taking the following cancer markers: cancer-embryonic antigen( REA),
  alphafetoprotein (AFP), SF199,
• Endoscopic retrograde cholangiopancreatography-examination of the state of the duodenum, pancreas and gallbladder by inserting a sensor into the duodenum,
• Laparoscopic staging-assessment of the prevalence of cancer by minimally invasive surgery, sometimes at the same time a biopsy is taken

Treatment of gallbladder cancer

Surgical radical

• Cholecystectomy-removal of the gallbladder,
• Advanced cholecystectomy-removal of the gallbladder and other organs or parts of organs (most often segments of the liver) due to the involvement of the oncological process in them,
• Liver transplantation-rarely used in clinical situations where the tumor has spread to the liver

Surgical palliative care (treatment that improves the condition, but does not
completely cure it)

• Cholecystostomy-creating a hole in the gallbladder, which allows you to
  remove bile from it with the help of drainage,
• Creating an anastomosis — in cases where the tumor blocks the natural bile outflow pathways, they are created artificially,
• Cytoreductive surgery-removal of the maximum possible tumor so that the tumor does not create mechanical obstacles to the outflow of bile
• Chemotherapy — not very effective for gallbladder cancer, but is used in the later stages,
• Radiation therapy-rarely used, usually to reduce pain,
• Photodynamic therapy-the use of light of a certain length in combination with a pharmaceutical product-a photosensebilizer-to destroy the tumor