TUMORS OF BILIARY TRACT
1. Carcinoma of the gallbladder
Carcinoma of gallbladder is rare and mostly associated with the presence of gallstones. About 90% of lesions are adenocarcinoma. It spread by direct invasion of adjacent structures, hematogenous, and lymphatic metastasis.
Symptoms: pain in the right upper quadrant which is not distinguishable from those pf gallstone symptoms. Jaundice, which indicate invasion of biliary tract and locally advanced tumor.
Signs: jaundice if the biliary tract is invaded and obstructed. mass may be palpable in the right upper quadrant due to the tumor or due to mucocele obstructed gallbladder.
Treatment
- Surgical resection is the best option for cure in resectable cases.
- Palliative percutaneous or endoscopic biliary stenting to relieve the obstructive jaundice.
2. Carcinoma of the bile ducts
Cholangiocarcinoma is a relatively uncommon cancer that affect the elderly. It can develop anywhere in the biliary tract, but sclerotic tumor in the biliary confluence is called “Klatiskin tumor”. It may develop in patients with primary sclerosing cholangitis or choledochal cyst.
Symptoms
- Vague dyspeptic pain in the right upper quadrant of the abdomen
- Progressive jaundice
- Anorexia
- Weigh loss
- Pruritus
- Acute cholecystitis, mucocele and empyema gallbladder my develop due to the obstruction of gallbladder.
Treatment
- Surgical resection is the best option for cure in resectable cases.
- Palliative percutaneous or endoscopic biliary stenting to relieve the obstructive jaundice.