{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T03:36:43Z","timestamp":1768275403025,"version":"3.49.0"},"reference-count":51,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2025,8,4]],"date-time":"2025-08-04T00:00:00Z","timestamp":1754265600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Gallbladder cancer (GBC) is a lethal malignancy curable only by surgical resection in early stages (Tis, T1, T2). Significant controversy exists regarding the optimal extent of surgery. This review summarizes recent trends and evidence on surgical strategies for Tis, T1, and T2 GBC to guide practice and research. Methods: This narrative review synthesizes recent literature on surgical management of Tis, T1a, T1b, and T2 GBC based on American Joint Committee on Cancer (AJCC) 8th edition staging. It examines simple vs. extended cholecystectomy (simple cholecystectomy (SC) vs. extended\/radical cholecystectomy (EC\/RC)), the role of lymphadenectomy (LND) and hepatectomy, and minimally invasive surgery (MIS). Results: Simple cholecystectomy is curative for Tis\/T1a GBC. For T1b, regional LND is essential for staging\/potential benefit, especially examining \u22655\u20136 nodes. Tumor size is critical; SC alone may suffice for T1b &lt; 1 cm (low lymph node metastasis (LNM) risk), while EC\/RC with LND is indicated for \u22651 cm (higher LNM risk). Routine hepatectomy for T1b lacks survival support. For T2 GBC, mandatory regional LND (\u22656 nodes) is required for both T2a and T2b substages due to high LNM rates; T2b has higher LNM than T2a. Routine hepatectomy for T2 is debated; evidence suggests no routine benefit for T2a beyond LND, with conflicting findings for T2b. R0 resection is paramount. MIS is feasible for early stages in experienced hands. Conclusions: Management of early GBC is moving towards risk stratification. SC is standard for Tis\/T1a. Adequate regional LND is crucial for T1b (especially \u22651 cm) and mandatory for T2 GBC. Routine hepatectomy, particularly for T2b, remains controversial. Tailored surgery prioritizes R0 resection and comprehensive LND, necessitating further standardized research.<\/jats:p>","DOI":"10.3390\/jcm14155483","type":"journal-article","created":{"date-parts":[[2025,8,5]],"date-time":"2025-08-05T08:46:55Z","timestamp":1754383615000},"page":"5483","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Recent Trends in Surgical Strategies of Early-Stage Gallbladder Cancer: A Narrative Review"],"prefix":"10.3390","volume":"14","author":[{"given":"Junseo","family":"Choi","sequence":"first","affiliation":[{"name":"School of Medicine, Konkuk University, Seoul 05029, Republic of Korea"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9501-9665","authenticated-orcid":false,"given":"Ji Su","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Surgery, Incheon St. Mary\u2019s Hospital, College of Medicine, The Catholic University of Korea, Seoul 21431, Republic of Korea"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9487-9826","authenticated-orcid":false,"given":"Jun Suh","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Surgery, Bucheon Sejong Hospital, Bucheon 14754, Republic of Korea"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1038\/s41572-022-00398-y","article-title":"Gallbladder cancer","volume":"8","author":"Roa","year":"2022","journal-title":"Nat. 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