Our Treatment Approach to Gallbladder Cancer

Gallbladder cancer is often in an advanced stage when it is diagnosed, requiring rapid intervention by a group of specialists experienced in treating the disease. The multidisciplinary team at City of Hope includes medical experts from the departments of Surgical Oncology, Medical Oncology and Radiation Oncology.

Surgery is an important treatment for localized tumors. When applicable, our specialists utilize minimally invasive surgery (MIS) with advanced technologies such as laparoscopy and the new da Vinci robotic surgery system that allows for greater precision. These surgeries feature small incisions and potentially:
  • less blood loss, pain and visible incisions
  • shorter hospital stay and recovery time
  • fewer complications and quicker return to normal activities
Often gallbladder cancer is treated with a cholecystectomy – the surgical removal of the gallbladder and some of the tissues around it. Nearby lymph nodes are also removed. If the cancer involves or is adjacent to the liver, a portion of the liver may need to be removed at the time of surgery.
If the cancer has spread and cannot be removed, the following types of palliative procedures may relieve symptoms:
  • Surgical biliary bypass: If the tumor is blocking the bile duct and bile is building up in the liver, a biliary bypass may be done. During this operation, the gallbladder or bile duct will be cut and sewn to the small intestine to create a new pathway around the blocked area.
  • Endoscopic stent placement:  If the tumor is blocking the bile duct, nonsurgical techniques can be used to put in a stent (a thin, flexible tube) to drain bile that has built up in the area. The stent may be placed through a catheter that drains to the outside of the body or the stent may go through the blocked area and drain the bile into the small intestine.
  • Percutaneous transhepatic biliary drainage: A procedure done to drain bile when there is a blockage and endoscopic stent placement is not possible. An X-ray of the liver and bile ducts is done to locate the blockage. Images made by ultrasound are used to guide placement of a stent, which is left in the liver to drain bile into the small intestine or a collection bag outside the body. This procedure may be done to relieve jaundice before surgery.
Radiation therapy uses energy beams to kill cancer cells. Specialists in the Department of Radiation Oncology have developed highly accurate new approaches that maximize the delivery of radiation to malignant cells while minimizing unnecessary exposure of healthy tissues. Therapeutic procedures include:

Chemotherapy – the use of anticancer medicines – includes a wide range of drugs and treatment strategies to treat primary and metastatic gallbladder cancer. City of Hope provides both standard chemotherapies as well as access to newly developed drugs through an extensive program of clinical trials.
As part of the treatment team, a medical oncologist will evaluate the best options, so that a course of chemotherapy, if appropriate, can be tailored to the patient.