Malignancies of the gallbladder and biliary tract, types of surgeries
1. Big picture
Gallbladder and biliary tract malignancies are aggressive surgical oncology diseases. The examiner mainly wants you to answer:
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Where is the tumour? Gallbladder, intrahepatic bile ducts, perihilar bile ducts, distal common bile duct, ampulla.
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Is it resectable? Curative treatment is possible only with R0 resection, meaning microscopically tumour-free margins.
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What operation fits the location? Gallbladder cancer → cholecystectomy ± liver bed resection and lymphadenectomy. Perihilar cholangiocarcinoma → bile duct resection + hepatectomy + caudate lobectomy + hepaticojejunostomy. Distal bile duct cancer → pancreaticoduodenectomy.
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Is there cholangitis or obstructive jaundice? Stabilize first, drain bile if needed, then plan definitive treatment.
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