The surgical management of incidental gallbladder carcinoma

Aims To report the surgical management of carcinoma of the gallbladder. Methods A retrospective study in 65 patients who underwent simple (SC) or extended (EC) cholecystectomy for gallbladder carcinoma. Results 28 patients underwent extended cholecystectomy (EC) and 37 had simple cholecystectomy (SC). The multivariate analysis showed that lymph-node status (positive vs negative, p=0.001, Hazard Ratio [HR]:14.2, 95% Confidence Interval [CI]:3.1–62.8) and type of surgery (SC vs EC, p=0.01, HR:10.2, 95% CI:1.7–62.8) were the most important prognostic factors related to death. This analysis indicated that EC in those with pT2 or pT3 was associated with a reduce hazard of death by 90% in the follow-up period. Conclusions In gallbladder cancer patients who diagnose after simple cholecystectomy, those with pT1 with clear margins need no further surgery. In patients with pT2 or pT3 incidental carcinoma, the completion radical re-operation is the only chance for long-term survival.