Timing of revision surgery for incidental gallbladder cancer: a systematic review and individual patient data meta-analysis
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Published on: May 2, 2025
B Selvakumar1, Shraddha Patkar2, Phani K Nekarakanti3
1Department of Surgical Gastroenterology, All India Institute of Medical Sciences (AIIMS), Jodhpur, India.
Aims:
We conducted this systematic review to answer the questions: a. what are the timing categories for revision surgery (RS) in incidental gallbladder cancer (iGBC)? b. which RS timing achieves better oncological outcomes?
Methods:
We performed literature search in 4 databases (PubMed, Scopus, Google Scholar and Cochrane Reviews) till 10th October 2025 and included studies which reported patient outcomes based on RS timing. Study characteristics, timing category definitions and RS outcomes were collected. (Study protocol PROSPERO ID CRD42023453990).
Results:
Twelve retrospective studies were included, with 2067 iGBC patients (566 males and 1346 females). On the 'Joanna Briggs Institute' (JBI) tool, most studies scored a 'Yes' to 7-8 out of 10 questions. There was no consensus on the definitions of 'early', 'intermediate' and 'delayed' timings for RS. Successful RS, perioperative morbidity, R0 resection were similar. On individual patient data meta-analysis, there was no difference in overall survival between RS at '4 weeks' [hazard ratio: 1.29, 95 % CI: 0.79-2.10].
Conclusion:
There was no consensus on the definitions of timing categories and optimum timing for RS in iGBC. Definitions of timing categories need to be standardised and future studies based on these categories may identify the ideal timing of RS in iGBC.
