A national incidental gallbladder cancer pathway: histology for every gallbladder, referral within two weeks, re-resection by eight

This is the UK baseline for the incidental cancer pathway: a re-resection rate well above the Dutch registry's 24 percent, with the same selection caveat. The abstract leaves out the histology, referral and timing detail; the full paper holds it.

It softens the Ethun four-to-eight-week rule: timing within the range that services can deliver probably matters less than completing the operation at all and doing it with the liver bed and nodes cleared.

Six per thousand is the number behind the debate on routine versus selective histology of gallbladder specimens: applied to a national cholecystectomy volume it predicts a few hundred unsuspected cancers a year in a country the size of England.

A whole-country picture of the gap between guideline and practice: three quarters of eligible patients never reached the second operation. The survival difference is confounded by selection but the residual disease rate is not.

The origin of the widely quoted four-to-eight-week window for re-resection. A 2026 individual patient data meta-analysis found no survival difference by timing, so the window is a reasonable planning target rather than a proven rule.