Cancer of the Gall Bladder and Biliary Tree

Malignancies of the gallbladder and bile ducts are uncommon tumors of the gastrointestinal tract. Presentation of gallbladder cancer can vary from an incidental pathologic finding after cholecystectomy to invasion of the liver, bile ducts and other perihepatic structures. Surgical resection is the mainstay of therapy; the extent of resection depends on the depth of tumor invasion into the gallbladder wall, liver, and invasion of local structures. Hilar cholangiocarcinoma (e.g. Klatskin's tumor) often presents with painless jaundice. Hepatic resection is usually required to achieve a potentially curative resection. Unfortunately, many tumors are unresectable at the time of presentation. Liver transplantation following neoadjuvant therapy has emerged as an effective treatment for selected patients with early stage hilar cholangiocarcinoma that is either unresectable or arising in the setting of primary sclerosing cholangitis.