Blood tests

The doctor will take a sample of blood and analyze it in a laboratory for any signs of the disease. The doctor will first determine the level of bilirubin in the blood. High levels of this substance may indicate gallbladder or liver problems. The doctor will also measure the levels of the CA 19-9 tumor marker. High levels of these substances may indicate gallbladder cancer or another type of cancer. The doctor may also perform a blood chemistry test, which measures the levels of various substances and provides important information on organ function.

• Please see Understanding Tumor Markers for more information

Ultrasound

Ultrasounds send out sound waves and pick up the echoes as they bounce off body tissues to create a black and white image of a part of the body. An ultrasound can help the doctor determine if there is a blockage in the gallbladder, how far it has spread into the gallbladder wall, and whether or not any nearby lymph nodes are enlarged. An ultrasound may also be used to help guide a needle biopsy. Your doctor may also recommend an endoscopic ultrasound which is a procedure in which an endoscope is inserted into the body, usually through the mouth. An endoscope is a thin, tube-like instrument with a light and lens for viewing.

Biopsy

If the tumor cannot be removed, a biopsy may be done using a fine needle to remove a tissue sample from the tumor. The sample is sent to a laboratory where a pathologist examines it under a microscope. If the tumor cannot be removed, the biopsy may be done using a fine needle to remove cells from the tumor. A biopsy is the only sure way to tell if cancer is really present.

Computed Tomography (CT) Scan

A computerized tomography (CT) scan uses X-rays to create detailed images of your internal organs. CT scans can help the doctor identify tumors in and around the gallbladder, and also whether or not the tumor has spread to nearby tissue, lymph nodes, or organs.

Magnetic Resonance Imaging (MRI) Scan

An MRI uses radio waves and a strong magnet to create clear and detailed images of body parts. Radio waves are absorbed by the body and then released in a certain pattern, which is translated by a computer in order to show "slices" of the body. An MRI scan produces detailed images of the pancreas, gallbladder, and bile ducts, and can help the doctor better examine these areas. The doctor may also perform a specialized scan called MRCP, magnetic resonance cholangiopancreatography which is used to examine the bile ducts and the pancreas.

Endoscopic Retrograde Cholangiopancreatography (ERCP) study

ERCP provides an X-ray image of the duct that carries bile through the abdomen. During ERCP, your doctor will inject a dye into the bile duct through a catheter inserted in the endoscope. This dye highlights the duct in the X-ray pictures your doctor will take as part of the procedure. The X-ray images can indicate the presence of a tumor. Additionally, if the duct is blocked by a tumor, a stent can be put in place to open the duct. ERCP is usually indicated if patient has jaundice.

Percutaneous Transhepatic Cholangiogram (PTC)

During PTC, a dye is injected through the skin into the liver. A special X-ray machine will determine if this dye is flowing freely through the bile ducts. If not, the X-ray pictures can show whether the blockage is caused by a tumor or another condition. At this time, your doctor can insert a small draining tube called a catheter to help with drainage of the bile if necessary.

Laparoscopy

A laparoscopy is a small operation used to visually examine your gallbladder, liver, and surrounding organs. The procedure involves creating a small incision in the abdomen and inserting a laparoscope (a thin tube containing a light and a camera) into your body. A biopsy sample may also be removed during the procedure.