2. Khyber Medical University
• Subject: adult health nursing
• Topics: Cancer of Gall Bladder
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3. Objectives
• At the end of this presentation the student will be
able to:
• Define gallbladder cancer.
• Describe Pathophysiology of gallbladder cancer.
• Enlist signs, symptoms and causes of gallbladder
cancer.
• Discuss medical diagnosis and treatment gallbladder
cancer.
• Make nursing diagnosis and nursing intervention for
gallbladder cancer.
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4. Gallbladder Cancer
• Cancer of the gallbladder is known as
gallbladder carcinoma. It is a disease
in which malignant (cancerous) cells
form in the tissues of the gallbladder.
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5. Pathophysiology
• Gallbladder cancer arises in the setting of chronic
inflammation. In the vast majority of patients (>75%),
the source of this chronic inflammation is cholesterol
gallstones. The presence of gallstones increases the risk
of gallbladder cancer 4- to 5-fold.
• Other more unusual causes of chronic inflammation
are also associated with gallbladder cancer. These
causes include primary sclerosing cholangitis,
ulcerative colitis, liver flukes, chronic Salmonella
typhi and paratyphi infections and Helicobacter
infection.
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6. • Sclerosis (from Greek σκληρός sklērós,
"hard") is the stiffening of a tissue or
anatomical feature, usually caused by a
replacement of the normal organ-specific
tissue with connective tissue. ...
Multiple sclerosis, or focal sclerosis, is a
central nervous system disease which
affects coordination.
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7. • a fluke which has a complex life cycle and
is of medical and veterinary importance.
The adult lives within the liver tissues of a
vertebrate, and the larva within one or
more secondary hosts such as a snail or
fish
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8. • Trematoda is a class within the phylum
Platyhelminthes. It includes two groups of
parasitic flatworms, known as flukes. They
are internal parasites of molluscs and
vertebrates. Most trematodes have a
complex life cycle with at least two hosts.
The primary host, where the flukes
sexually reproduce, is a vertebrate
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9. Etiology
• Following are the risk factors for
gallbladder cancer.
• Female sex.
• Cholelithiasis
• Cholecystitis.
• Chemical Carcinogens.
• Obesity.
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10. Signs & Symptoms
• Steady pain in the upper right abdomen
• Weakness
• Loss of appetite
• Weight loss
• Jaundice and
• Nausea and Vomiting.
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11. Diagnosis
Gallbladder cancer are diagnosed by the
following:
• Physical exam and history
• Ultrasound & CT-scan.
• MRI.
• Liver function tests.
• Biopsy.
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13. Complications
Complications of gallbladder cancer include:
• Pneumonia.
• Malabsorption.
• Persistent vomiting.
• Rashes and other skin changes (discoloration).
• Weight loss.
• Bone marrow damage.
• Constipation and diarrhea.
• Hair loss.
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14. Nursing diagnosis
• Acute pain related to gallbladder inflammation or
presence of stones.
• Ineffective breathing pattern related to pain from
high abdominal incision.
• Imbalanced nutrition less than body
requirements related to altered lipid metabolism
and increased nutritional needs during healing.
• Risk for infection related to complications of
disease.
• Stress and anxiety related to disease.
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15. Nursing interventions
• Monitor and record vital signs.
• Administer medication as ordered.
• Administer analgesic agents as ordered.
• Place the patient in low Fowler’s position to
facilitates breathing.
• Monitor nutritional intake and weigh patient
regularly.
• Encourage the patient and provide emotional
support to the patient.
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16. References
• Huffman JL, Schenker S. Acute acalculous cholecystitis - a review. Clin
Gastroenterol Hepatol. Sep 9 2009;[Medline].
• Donovan JM. Physical and metabolic factors in gallstone
pathogenesis. Gastroenterol Clin North Am. Mar 1999;28(1):75-
97. [Medline].
• Sitzmann JV, Pitt HA, Steinborn PA, et al. Cholecystokinin prevents
parenteral nutrition induced biliary sludge in humans. Surg Gynecol
Obstet. Jan 1990;170(1):25-31. [Medline].
• Cullen JJ, Maes EB, Aggrawal S, et al. Effect of endotoxin on opossum
gallbladder motility: a model of acalculous cholecystitis. Ann Surg. Aug
2000;232(2):202-7. [Medline].
• Forbes LE, Bajaj M, McGinn T, et al. Perihepatic abscess formation in
diabetes: a complication of silent gallstones. Am J Gastroenterol. Apr
1996;91(4):786-8. [Medline].
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