Management

For management of disease limited to the mucosa, cholecystectomy is adequate. Tumor invading the muscularis or serosa requires cholecystectomy and wedge resection of a 2-3 cm liver bed margin adjacent to the gallbladder bed with lymph node dissection. If the tumor extends beyond the gallbladder, resection includes all of the previous, and additionally the adjacent common bile duct, then hepaticojejunostomy. Palliation for patients with unresectable disease includes systemic chemotherapy and regional radiotherapy with very low response rates. Choledochojejunostomy or hepaticojejunostomy can be utilized to relieve obstructive jaundice. If excessive operative risk is present, transhepatic or endoscopic stenting may be preferred.

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