title: Clinical characteristics of incidental or unsuspected gallbladder cancers diagnosed during or after cholecystectomy: a systematic review and meta-analysis.
abstract: OBJECTIVE
  To perform a systematic review of incidental or unsuspected gallbladder (GB) cancer diagnosed during or after cholecystectomy.
  
  
  METHODS
  Data in PubMed, EMBASE, and Cochrane Library were reviewed and 26 publications were included in the meta-analysis. The inclusion criterion for incidental GB cancer was GB cancer diagnosed during or after cholecystectomy that was not suspected at a preoperative stage. Pooled proportions of the incidence, distribution of T stage, and revisional surgery of incidental GB cancer were analyzed.
  
  
  RESULTS
  The final pooled population comprised 2145 patients with incidental GB cancers. Incidental GB cancers were found in 0.7% of cholecystectomies performed for benign gallbladder diseases on preoperative diagnosis (95%CI: 0.004-0.012). Nearly 50% of the incidental GB cancers were stage T2 with a pooled proportion of 47.0% (95%CI: 0.421-0.519). T1 and T3 GB cancers were found at a similar frequency, with pooled proportions of 23.0% (95%CI: 0.178-0.291) and 25.1% (95%CI: 0.195-0.317), respectively. The pooled proportion that completed revisional surgery for curative intent was 40.9% (95%CI: 0.329-0.494). The proportion of patients with unresectable disease upon revisional surgery was 23.0% (95%CI: 0.177-0.294).
  
  
  CONCLUSIONS
  A large proportion of incidental GB cancers were T2 and T3 lesions. Revisional surgery for radical cholecystectomy is warranted in T2 and more advanced cancers.
authors: Kui Sun Choi, Sae Byeol Choi, Pyoungjae Park, Wan Bae Kim, Sang Yong Choi, Department of Surgery, Korea University College of Medicine, Seoul 152-703, South Korea.
authors: Kui Sun
authors: KS
authors: Choi
authors: Kui Sun Choi, Sae Byeol Choi, Pyoungjae Park, Wan Bae Kim, Sang Yong Choi, Department of Surgery, Korea University College of Medicine, Seoul 152-703, South Korea.
authors: Sae Byeol
authors: SB
authors: Choi
authors: Kui Sun Choi, Sae Byeol Choi, Pyoungjae Park, Wan Bae Kim, Sang Yong Choi, Department of Surgery, Korea University College of Medicine, Seoul 152-703, South Korea.
authors: Pyoungjae
authors: P
authors: Park
authors: Kui Sun Choi, Sae Byeol Choi, Pyoungjae Park, Wan Bae Kim, Sang Yong Choi, Department of Surgery, Korea University College of Medicine, Seoul 152-703, South Korea.
authors: Wan Bae
authors: WB
authors: Kim
authors: Kui Sun Choi, Sae Byeol Choi, Pyoungjae Park, Wan Bae Kim, Sang Yong Choi, Department of Surgery, Korea University College of Medicine, Seoul 152-703, South Korea.
authors: Sang Yong
authors: SY
authors: Choi
mesh_terms: D002763:Cholecystectomy; D005706:Gallbladder Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology / Q000601:surgery; D006801:Humans; D015994:Incidence; D033162:Incidental Findings; D009367:Neoplasm Staging; D012086:Reoperation; D012307:Risk Factors; D016896:Treatment Outcome
keywords: Cholecystectomy; Gallbladder cancer; Incidental diagnosis; Laparoscopic surgery; Revisional surgery
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