GALL BLADDER CANCER AND GALL STONE.

          People with a history of gallstones have an increased risk of gallbladder cancer. But gallbladder cancer is very rare disease. Even though the risk of cancer is elevated in gall stone disease, the likelihood of gallbladder cancer is still very small. But one important association between gall stone and gall bladder cancer is that if the stone size is more than 15 mm, then there is more possibility of developing gall bladder cancer after sometime. It has been proposed that bacterial degradation of bile salts and chronic cholecystitis (gall bladder inflammation) related to gallstones could promote the development of gall bladder carcinomas^. Also, if the gall stones are associated with gall bladder polyps, then there is a higher possibility of the development gall bladder cancer.

          Gall bladder cancer may present with symptoms of gall stone disease or may present with features suggestive of gall bladder cancer with distant spread. Routine investigations like ultrasonography of abdomen make a diagnosis gall bladder cancer. But, PET scan to some extent confirms the diagnosis of gall bladder cancer. Whole body PET scanning is very useful in case of suspected gall bladder cancer to plan management protocol, especially for surgical management. Simple gall stone disease the treatment is laparoscopic cholecystectomy. But in case of gall bladder cancer the treatment is radical laparoscopic cholecystectomy or radical open cholecystectomy. In radical cholecystectomy, the technical difference is that the Calot’s lymph node along with   all the lymphatics and soft tissue present in the Calot’s triangle will be removed. Also, liver tissue, approximately about 1cm close to gall bladder (Liver bed) will also be removed to clear all tumour tissue. In case of laparoscopic radical cholecystectomy, the specimen will be retrieved through endo-bag.