What is the treatment protocol for gallbladder cancer when T1b or higher?

In the context of gallbladder cancer, particularly when the tumor is classified as T1b or higher, the management protocol requires a more aggressive approach. T1b indicates that the cancer has invaded the muscularis propria of the gallbladder wall. As such, surgical intervention goes beyond mere cholecystectomy, which primarily removes the gallbladder without addressing the tumor's invasive characteristics or surrounding tissues.

The correct treatment involves considering a more extensive surgical resection, like skeletonizing the area around the gallbladder and performing a wedge resection. This approach allows for the removal of not just the gallbladder but also the surrounding tissues that may be affected by cancer. By resecting adjacent structures, including potential regional lymph nodes, the procedure aims to improve the likelihood of complete tumor removal and reduce the chance of recurrence.

Other options, such as cholecystectomy only, would not be sufficient for T1b or higher lesions since it neglects the need to address surrounding tissues where metastasis could occur. Observation and immediate chemotherapy would also not adequately address the localized nature of the disease and could allow for cancer progression, compromising patient outcomes. Thus, the comprehensive surgical plan involving skeletonization and wedge resection is the standard for