Gallbladder Cancer Biopsy & Pathology

Often, gallbladder cancer is discovered after your gallbladder is removed for gallstone disease. If this happens, your surgeons may recommend further surgery to ensure all the cancer has been removed and to “stage” your disease.

Your doctors may determine that removing your gallbladder alone is sufficient. If your doctors recommend further surgery, they may suggest removing part of your liver near where your gallbladder was, some nearby lymph nodes and a sample or part of your common bile duct. These tissues will be sent to a pathologist for examination.

If your gallbladder was not removed but your doctors suspect gallbladder cancer, they will want to remove some tissue or fluid from your body to examine it under a microscope. Once your doctors have removed a small piece of tissue or fluid from your gallbladder or bile ducts, they send it to a pathologist to be evaluated. Biopsy and pathology reviews are the only way to accurately identify cancer. Sometimes a biopsy will show you have a condition that is not yet cancerous but which may lead to cancer.

Your doctors may use results of some diagnostic imaging tests to recommend a particular type of biopsy. For suspected gallbladder cancers, your doctors may remove the tissue by using a needle and guiding it to your gallbladder while viewing a CT or ultrasound image. They also may remove tissue while doing an endoscopic or laparoscopic examination.


Your pathologist, who is board-certified, will look at your tissue samples under a microscope to see if cancer cells are present. Biopsy and pathology reviews are the only way to accurately identify cancer. Your pathologist also will check for the specific type of cancer, indications of how far it has spread and whether it has tumor markers which could help your doctors recommend treatment. Knowing the exact type of cancer you have will help your doctors devise a better treatment plan for you.

Tumor markers

Tumor markers are proteins released by tumors. Sometimes these substances occur in a natural, healthy way in your body and are released at higher levels when a cancerous tumor begins to grow. Sometimes they may indicate other diseases. Doctors use them to help pinpoint a specific type of cancer or to eliminate it from consideration. These include:

  • Carcinoembryonic antigen assay

    You may hear this called CEA. It’s normally found in small amounts in your blood but may appear in higher than normal levels if you have gallbladder cancer. Other cancers also can cause it to rise.

  • CA19-9 assay

    This is a tumor marker which may indicate you have cancer in your gallbladder, bile ducts, colon, stomach or pancreas. Sometimes levels will be elevated if you have noncancerous conditions such as gallstones so your doctors will use results of this test in concert with other tests. If you have gallbladder cancer, your doctors may measure for this substance periodically to evaluate how you are responding to treatment.