{"entity":{"id":"paper-soreide-incidental-gallbladder-cancer-review-bjs-2019","kind":"paper","name":"Systematic review of management of incidental gallbladder cancer after cholecystectomy","aka":[],"tldr":"A British Journal of Surgery review of what to do when a gallbladder removed for stones turns out to hold cancer: about one in 200 do, tumours confined to the lining are cured by the first operation, deeper ones need a second, and cutting out the keyhole port sites does not help.","summary":"Systematic review (PubMed to May 2018) from Edinburgh identifying 12 systematic reviews and meta-analyses plus consensus reports, multi-institutional series and national audits. Incidental gallbladder cancer was found in 0.25 to 0.89 percent of cholecystectomy specimens; about half were pT2 and a third pT1. Five-year survival after cholecystectomy alone was up to 100 percent for T1a or less; re-resection is recommended from T1b, though its type, extent and timing remain controversial. Perforation at the first operation raised dissemination risk; PET is useful for residual disease; routine laparoscopic staging is not warranted for all stages; port-site metastases occur in about 10 percent and routine port-site resection does not affect survival; adjuvant chemotherapy is poorly documented and probably underused.","asOf":"2026-09-24","links":[{"label":"Br J Surg 2019","url":"https://doi.org/10.1002/bjs.11035"},{"label":"PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/30582640/"}],"tags":["gallbladder-evidence"],"related":[],"cancers":["gallbladder"],"sections":[],"technologies":["pet-ct"],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":["incidental-gallbladder-cancer","radical-cholecystectomy"],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"journal":"British Journal of Surgery","year":2019,"doi":"10.1002/bjs.11035","pmid":"30582640","authors":"Søreide K, Guest RV, Harrison EM, et al.","paperType":"review","findings":["Incidental gallbladder cancer in 0.25 to 0.89 percent of cholecystectomy specimens; about half pT2, a third pT1.","Five-year survival up to 100 percent after cholecystectomy alone for T1a or less; re-resection recommended for T1b or above.","Port-site metastases about 10 percent; routine port-site resection has no effect on survival."],"whatItMeans":"The UK-authored summary that most NHS hepatobiliary units work from; it names the open questions (type, extent and timing of re-resection; adjuvant chemotherapy) that the trials in this roadmap are trying to answer.","caveats":["Narrative synthesis of heterogeneous retrospective data.","Predates BILCAP's publication and the immunotherapy trials."],"changedPractice":false},"route":"/key-papers/paper-soreide-incidental-gallbladder-cancer-review-bjs-2019/","neighbours":{"cancer":[{"id":"gallbladder","kind":"cancer","name":"Gallbladder cancer","route":"/cancers/gallbladder/"},{"id":"incidental-gallbladder-cancer","kind":"cancer","name":"Incidental gallbladder cancer (found after cholecystectomy)","route":"/cancers/incidental-gallbladder-cancer/"}],"technology":[{"id":"pet-ct","kind":"technology","name":"PET/CT","route":"/technologies/pet-ct/"}],"term":[{"id":"radical-cholecystectomy","kind":"term","name":"Radical (extended) cholecystectomy","route":"/terms/radical-cholecystectomy/"}],"roadmap":[{"id":"gallbladder-cancer-roadmap","kind":"roadmap","name":"Gallbladder cancer roadmap: from a chance finding at gallstone surgery to a disease with its own trials","route":"/roadmaps/gallbladder-cancer-roadmap/"}]}}