Biliary tract tumors can be divided into two main categories: gallbladder cancers and cholangiocarcinomas. The two groups differ in their patterns of spread and in prognosis. Gallbladder cancer tends grow more rapidly and has earlier dissemination which makes staging laparoscopy a more useful tool in this setting. In contrast, cholangiocarcinomas tend to be more locally invasive, decreasing the yield of staging laparoscopy. Preoperative imaging to determine resectability of biliary tract cancers often includes ultrasound, CT scan, direct cholangiography (PTC or ERCP), and/or MRCP. These radiologic preoperative studies are used to evaluate the extent of tumor within the biliary tree, vascular invasion, hepatic lobar atrophy, and metastatic disease.
Many gallbladder cancers are incidental findings during or after laparoscopic cholecystectomy. For patients with T2 lesions or greater, liver resection along regional lymphadenectomy is indicated as a secondary procedure, therefore obviating the need for staging laparoscopy .