Carcinoma Gallbladder: by Prof. Dr. Banabihari Mishra SCB Medical College, Cuttack
Carcinoma Gallbladder: by Prof. Dr. Banabihari Mishra SCB Medical College, Cuttack
Carcinoma Gallbladder: by Prof. Dr. Banabihari Mishra SCB Medical College, Cuttack
By
Prof. Dr. Banabihari Mishra
SCB Medical college, Cuttack
ANATOMY
SEGMENTS
BLOOD SUPPLY
VENOUS DRAINAGE
LYMPHATIC DRAINAGE
Epidemiology
• ~5,000 - <10,000 new cases annually diagnosed in US
• Highest in Southwest, Midwest, and Appalachia
• Native Americans > Whites > African Americans
• Most common malignancy of the biliary tract. 5th
most common of the gastrointestinal system
• Mean age at diagnosis is 65 years old
• More common in females:
• 2.5:1
• 15:1 (<40 years of age)
• American Indians 6x higher than the
general population
• Chile has the highest rate of GBC in the
world
Risk Factors
• Gallbladder Stones
• Porcelain Gallbladder ?
• Multiparas ≥ 3
• Obesity
• Chronic cholecystitis, chronic mucosal
damage
• Polypoidal lesions of the gallbladder
• Bacterial Infections
• Genetic
predisposition
• Exposure to
carcinogens
2 hypothesis linking epidemiology
and molecular pathogenesis
Chlelithiasis Anomalous
Pancreaticobiliary Duct
Junction
Chronic inflammation K-ras point mutation
missence p53 atypical epithelium
mutation genetically carcinoma
damaged cells survive
inappropriately
Relative Frequencies of Gallbladder
Malignancies
Tumor Type Percent of Total
Adenocarcinoma 75.8
Papillary 5.8
Mucinous 4.6
Adenosquamous 3.6
Oat cell 0.5
Nonspecific 7.6