Liver & Gall Bladder Cancer

Liver, gall bladder, bile duct & pancreatic tumor surgeries can be performed by conventional open method or by laparoscopy. Laparoscopic or Keyhole cancer surgery has several advantages over conventional open surgery with same cure rate. Only surgery is curative in these tumors and cancers. Additional therapies (chemotherapy & radiotherapy) are mostly supportive. But, many patients and their relatives try to avoid surgery for the fear of the immense trauma for their loved ones, resulting in patient getting wrong or less effective treatment. With laparoscopy the trauma is much less and makes the treatment more acceptable. The Team MACS precisely addresses all these issues and works relentlessly for a better life.

comparing the wounds
Dr. Sandeep Nayak


MBBS, MRCSEd, DNB (Gen Surg),
MNAMS (Gen Surg), DNB (Surgical Oncology),

Fellowship in Laparoscopic and Robotic Onco-Surgery.
Dr Nayak is one of the leading senior Surgical Oncologists (cancer surgeon) of Bangalore. He is one of the pioneers of Laproscopic (laparoscopic) cancer treatment (surgery). He is the Director of Surgical Oncology at Fortis Hospital, Bangalore.

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About Liver & Gall Bladder

Liver & gall bladder are closely related organs. The affliction of one can affect the function of the other. That is the reason why these need to be dealth with together.
Liver is the largest gland in the body weighing about 3 kg. Liver is located under the right rib cage. It is one of the most important organs involved in cleaning blood. It produces bile which is needed to digest fat. Liver is also involved in clearing many toxic chemicals form blood.Apart from primary cancers, liver is a common place of spread of cancer forms other cancers like colon & rectum (metastasis).
Gall bladder stores bile and releases it only when food reaches intestine.

Symptoms And Diagnosis

The early cancer of liver and gall bladder notoriously do not produce any symptoms. They are most curable when they are detected before causing symptoms. Most of the early and treatable cancers are detected during routine ultrasound scans or scans done for other reasons. However, when symptoms start, most common symptom of tumor of liver & gall bladder are:

  • Unexpected weight loss& loss of apatitecould be one of the earliest symptoms. This occurs because of changes in digestion.
  • Vague pain in the upper part of abdomen could be the only symptom of liver cancer.
  • Jaundiceis when eyes turn yellow. This occures very late in liver and gall bladder cancers. However, it occures early in case of cancers of common bile duct and pancreas.
  • The diagnosis is reached based on investigations which include various blood tests including liver functions tests and imaging tests like CT scan and MRI scan. If the investigations shows a cancer far too progressed for a curative procedure, then only a needle biopsy is planned.

Treatment Of Liver Tumors

Surgery is the only treatment that can cure liver cancer. Surgical removal of cancer bearing portion of liver is the treatment of choice when it is feasible. This is the same for both primary liver cancers &for metastasis (spread from cancers of colon, rectum & some other tumors). Surgery is feasible when the liver tissue left behind after surgery (FLR) is sufficient for patient’s survival. This is calculated using specialized CT scan. Surgery can range from a wedge resection of the tumor to major liver resections like right or left hepatectomy. Most these surgeries can be performed by conventional open method or robotically or laparoscopically with similar results.

Treatment Of Gall Bladder Cancers

This cancer is very often diagnosed at the time of surgery for gall bladder stones or thereafter in the biopsy report. Sometimes this may be suspected on ultrasound examination or CT scan. A needle biopsy should never be performed on a suspected gallbladder cancer as this can spread the disease unless it is already confirmed to be spread.The treatment involves removal of a gallbladder along with portion of liver and lymph nodes (radical cholecystectomy). Sometimes bile duct may also have to be removed. If the gall bladder has already been removed, a completion radical cholecystectomy is necessary. These surgeries can be performed by conventional open method or robotically or laparoscopically with equal results. While performing this surgery all care is taken not to contaminate rest of the abdomen.