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№ 8Thematic Questions20 min read

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:

  1. Where is the tumour? Gallbladder, intrahepatic bile ducts, perihilar bile ducts, distal common bile duct, ampulla.

  2. Is it resectable? Curative treatment is possible only with R0 resection, meaning microscopically tumour-free margins.

  3. 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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