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Risk Factors and Clinical Predictors Associated with Incidental Gallbladder Cancer: A Systematic Review and

Thilagavathi Ramamoorthy1, Vaitheeswaran Kulothungan1, Saravanan Vijayakumar1

  • 1Indian Council of Medical Research - National Centre for Disease Informatics and Research, Nirmal Bhawan-ICMR Complex (II Floor), Poojanahalli Road, Off NH-7, Adjacent to Trumpet Flyover of BIAL, Bengaluru, Karnataka, Kannamangala post Bengaluru 562110, India.

Journal of Gastrointestinal Cancer
|December 29, 2025
PubMed
Summary

This study identifies key predictors of incidental gallbladder cancer (IGBC) in patients undergoing cholecystectomy. Advanced age, female gender, elevated alkaline phosphatase, and larger polyps are associated with IGBC, guiding earlier detection.

Keywords:
CholecystectomyGallbladder cancerIncidentalRisk factorsUnsuspected

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Area of Science:

  • Gastroenterology
  • Surgical Oncology
  • Epidemiology

Background:

  • Gallbladder cancer (GBC) is a significant cause of cancer mortality globally.
  • Incidental gallbladder cancer (IGBC) is frequently diagnosed post-cholecystectomy for presumed benign conditions.
  • Limited comprehensive data exists on predictors for IGBC.

Purpose of the Study:

  • To synthesize risk factors and clinical predictors associated with IGBC.
  • To identify patient characteristics that increase the likelihood of incidental gallbladder cancer.
  • To inform preoperative evaluation and intraoperative strategies for patients undergoing cholecystectomy.

Main Methods:

  • Systematic review and meta-analysis of observational studies (Jan 2010 - Feb 2024).
  • Searched EMBASE, PubMed-MEDLINE, and Scopus databases.
  • Assessed heterogeneity using I² statistic and conducted sensitivity analyses.

Main Results:

  • 18 studies (788,214 patients) were included.
  • Predictors of IGBC included: advanced age (OR 1.09), female gender (OR 1.91), elevated alkaline phosphatase (OR 1.68), polyp size >10 mm (OR 8.63), and open cholecystectomy (OR 9.20).
  • Large gallstones (>3 cm) showed no significant association.

Conclusions:

  • Key demographic and clinical factors associated with IGBC have been identified.
  • Findings support risk-based preoperative evaluation and intraoperative vigilance.
  • Incorporating predictors can enhance early GBC detection and improve patient outcomes.