The best and most effective treatment for cancer of the gallbladder is an operation to remove the gallbladder and the cancer (a cholecystectomy).
 
If the cancer is discovered at a very early stage, when it is still limited to the lining of the gallbladder, then removal of the gallbladder is all that is needed (a simple cholecystectomy). 

However, if the cancer has begun to invade into the wall of the gallbladder the risk of spread to nearby lymph nodes, or the liver, is increased and a more major operation called a radical, or extended, cholecystectomy is needed.  This will involve removal of the gallbladder, together with some of the surrounding normal tissue including blood vessels, lymph nodes and part of the nearby liver.
 
Giving radiotherapy to the gallbladder area after an operation can sometimes improve the chances of a cure, as can the use of chemotherapy.
 
Unfortunately many gallbladder cancers are only discovered at a late stage, when they have already spread too far for an operation.  In this situation jaundice is usually the main problem, due to tumour blocking the nearby bile ducts and treatment is directed to easing this.  In the past this has often involved an operation but nowadays ‘stenting’ offers an alternative.  This may be done in one of two ways:

• percutaneous stenting:  this is where a fine tube is inserted through the skin of the lower part of the chest, into the liver, and passed through into the bile ducts. A guide wire is threaded through this tube, which is then removed, a metal coil, or stent, is then slipped over the guide wire and slid along to where the tumour is in the bile duct.  The stent can then be expanded to open up the duct and relieve the blockage. The guide wire is then removed and the stent is left in the bile duct.
• endoscopic stenting: this is a very similar process but this time the stent is introduced through an endoscope, a flexible tube which is swallowed and reaches the bile duct by passing through the gullet, the stomach and the first part of the small intestine: the duodenum.

Radiotherapy and chemotherapy are not very helpful in more advanced gallbladder cancers.  Occasionally chemotherapy treatment, such as gemcitabine, or a combination of drugs such as  fluorouracil, Adriamycin and mitomycin (FAM) may give some temporary improvement.