Gallbladder cancer (GBC) is a rare though notoriously lethal malignancy with marked ethnic and geographical variations. In India, GBC is most prevalent in the northern and northeastern states of Uttar Pradesh, Bihar, Orissa, West Bengal and Assam. It is twice more common in women than in men and is the commonest digestive cancer in women in northern India.

Apart from gallstones, female gender, ethnicity, genetic susceptibility and lifestyle factors are associated risk factors in the development of GBC.

The presenting symptoms are typically vague and are akin to other diseases such as cholelithiasis and cholecystitis. There are no biochemical tests of importance for early diagnosis. A raised bilirubin is a sign of advanced disease.

Tumor Markers – CEA and CA 19-9 do not have much role in diagnosis as these are not specific for GBC. Various imaging tools available include Ultrasound (USG), Computed Tomographic (CT) scan, and Magnetic Resonance Imaging (MRI) with Magnetic Resonance Cholangiopancreatography(MRCP) and Magnetic Resonance Angiography (MRA).

Amidst very poor prognosis i.e. 5% 5-year survival in GBC, complete surgical resection (R0) is the only hope for long term survival.

The approach to surgical management of GBC (extended cholecystectomy) is influenced by mode of spread of GBC to liver, lymphatic and vascular invasion; direct spread to contiguous organs and intraperitoneal seeding and luminal through the cystic duct (intraductal).