Diagnosis of Gall bladder cancer

How is the diagnosis made?

Many gallbladder cancers are discovered when a pathologist examines a gallbladder that has been removed for symptoms of gallstones. But many gallbladder and most bile duct cancers are found only after related signs and symptoms appear. The doctor conducts a physical exam and the following tests:

1. Blood tests: This is to check for elevated levels of bilirubin or the enzyme alkaline phosphatase.
   
2. Ultrasound: Ultrasound is usually one of the first tests done in the evaluation of patients with jaundice and is especially good at diagnosing the presence of gallstones and obstructed bile ducts. It can also show the presence and extent of tumours.
   
3. CT scan: This helps determine if cancerous cells have spread to the common bile duct, lymph nodes or the liver.
   
4. MRI: This test uses a powerful magnetic field and radio waves to create images and can help determine whether the flow of bile is blocked or a tumour has invaded the liver.
   
5. Endoscopic retrograde cholangiopancreatiography (ERCP): This test is most sensitive for detecting an obstruction of the bile ducts and its cause, and can also be used in preparation for surgery. ERCP can also allow a biopsy to be performed, confirming a diagnosis.
   
6. Laparoscopy: This is often used to confirm how far the cancer has spread.

Biopsy:In this procedure, a small sample of tissue is removed and examined for cancerous cells under a microscope. It is the only way to make a definitive diagnosis of cancer.