There is one lady in my family report after ct scan kindly help me what to do in this case? Report conclusion malignant mass lesion in gb fossa region involving the gall bladder as well as adjacent hepatic parenchyma with infiltration of the hepatic flexure of colon, pylorus and first part of duodenum as detailed above most likely primary gall bladder neoplasm.

Dr. Nikhilesh BorkarOncologist14yrs exp

94% (196 ratings)

Ask Free Question

It is an advanced gall bladder cancer infiltrating adjoining organs. Will need to study the CT scans for exact opinion. The points for resection vs palliation are: 1) Presence of jaundice makes her unlikely candidate for curative surgery. Also the patients general condition will dictate the strategy. 2) The ct scan findings of major vessel involvement or N2 nodal involvement, ascites, extensive disease along hepatoduodenal involvement, liver or peritoneal metastasis. 3) Even if above contraindications are not present, I prefer to get a PET CT scan done as it may change the staging in about 20-25 % cases. 4) I prefer to do a diagnostic lap before surgery as peritoneal mets may be missed on imaging. 5) Despite all precautions, the disease may be inoperable on opening the abdomen. 6) Some prefer the option of upfront chemotherapy or chemoradiotherapy to shrink the disease and then plan for surgery if good response, others prefer radical surgery upfront. Irrespective the prognosis of such advanced disease is not very good. If inoperable then palliative procedures are done like 1) Percutaneous or endoscopic biliary drainage. 2) Duodenal stenting to avoid obstruction. 3) Biliary mainly segment III cholangiojejunostomy (away from bile duct) 4) Palliative radiotherapy or Chemoradiation 5) Palliative chemotherapy I hope I was able to solve your queries. If you want to send the scans and discuss in details, donot hesitate to contact me.  

1 person found this helpful