— gall bladder disease presents generally in middle-aged to elderly females with dyspepsia, bloating and right hypochondrial pain. Investigation includes liver function tests and abdominal ultrasound scan looking for luminal/mural lesions, calculi or large duct obstruction. If abnormal, CT scan and cholangiography [percutaneous or at endo-scopic retrograde cholangiopancreatography (ERCP)] are of use in demonstrating and staging a tumour mass.

— laparoscopic/open cholecystectomy. Most gall bladder cancers are an incidental finding after routine cholecystectomy. Rarely, they are submitted as part of an elective extended cholecystectomy—after determination of the extent of local spread by operative ultrasound the hepatic gall bladder bed and regional nodes are resected. A deeper tumour may require hepatic segmental resection.

— contents: bile/calculi (number, size, shape, colour).

— lymph nodes: site/size/number.

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