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Management of Jaundice in Gallbladder Cancer

Gallbladder Neck mass causing compression at the hilum resulting in biliary tract obstruction is the most common cause of jaundice in Gallbladder Cancer patient
There can be two conditions in these patients
(A) Tumor is resectable, Surgery is the treatment of choice, but as these patients also require Liver resection and liver resection in jaundice patients can lead to liver failure, it is important to reduce the bilirubin before surgery, Endoscopic biliary drainage is preferred if possible otherwise percutaneous transhepatic biliary drainage is done (PTBD); Once the bilirubin level comes down after these procedures surgery is planned according to the tumor site, Most commonly these patients require extended right hepatectomy
(B) Tumor is unresectable, in case of locally advanced tumor or metastatic tumor patient require palliation for jaundice; Endoscopic biliary drainage if possible is done and metallic biliary stenting is done, advantage of metallic biliary stenting being less chances of blockage; if endoscopic biliary drainage is not possible then percutaneous transhepatic biliary drainage (PTBD) is done