{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T22:09:56Z","timestamp":1778278196869,"version":"3.51.4"},"reference-count":36,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T00:00:00Z","timestamp":1778198400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Incidental gallbladder cancer (IGBC) is an uncommon but clinically important diagnosis after cholecystectomy for presumed benign biliary disease. This study aimed to determine the incidence of invasive IGBC in a large cholecystectomy cohort and to describe its clinicopathological profile, stage-specific management pathway, and exploratory univariable survival associations. Materials and Methods: We retrospectively reviewed all cholecystectomies performed between January 2010 and December 2025 at a tertiary referral center (n = 19,798). Patients with known preoperative gallbladder cancer and those with incomplete data precluding reliable staging or survival assessment were excluded. Only invasive IGBC was analyzed; dysplasia and carcinoma in situ were excluded a priori. Overall survival (OS) was defined from index surgery to death from any cause, and disease-free survival (DFS) was assessed in patients with non-metastatic disease at baseline. Survival was estimated using Kaplan\u2013Meier methods, and associations with survival outcomes were explored using univariable Cox regression. Results: IGBC was identified in 43 patients (0.22%). Adenocarcinoma predominated, pT2 was the most frequent pathological stage, and 11 patients (25.6%) had pT3\u2013T4 disease. Staged re-resection was performed in 12 patients (27.9%). Median OS was 48.0 months (95% CI, 34.0\u201362.0), and median DFS in the M0 cohort was 80.0 months (95% CI, 9.5\u2013150.5). The 2-, 4-, and 6-year OS rates were 78.2%, 48.3%, and 38.8%, respectively; the corresponding DFS rates were 70.4%, 59.3%, and 50.8%. In exploratory univariable analyses, pathological T stage showed the most consistent unadjusted association with OS and DFS, whereas margin positivity, perineural invasion, lymphovascular invasion, and increasing tumor size were associated with worse DFS. Conclusions: Although rare, IGBC may present with advanced pathological features despite presumed benign disease. These findings support meticulous pathological assessment, structured postoperative staging, and risk-adapted multidisciplinary management. Given the limited sample size and exploratory, unadjusted analyses, survival associations should be interpreted cautiously.<\/jats:p>","DOI":"10.3390\/medicina62050915","type":"journal-article","created":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T21:07:16Z","timestamp":1778274436000},"page":"915","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Incidental Gallbladder Cancer After Cholecystectomy for Presumed Benign Biliary Disease: A Sixteen-Year Retrospective Cohort Study from a Tertiary Referral Center"],"prefix":"10.3390","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1333-5059","authenticated-orcid":false,"given":"G\u00f6kay","family":"\u00c7etinkaya","sequence":"first","affiliation":[{"name":"Kartal Dr. L\u00fctfi K\u0131rdar City Hospital, 34862 \u0130stanbul, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmet","family":"Ba\u015fkent","sequence":"additional","affiliation":[{"name":"Kartal Dr. L\u00fctfi K\u0131rdar City Hospital, 34862 \u0130stanbul, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0063-8798","authenticated-orcid":false,"given":"Mehmet Furkan","family":"Ba\u015fkent","sequence":"additional","affiliation":[{"name":"Kartal Dr. L\u00fctfi K\u0131rdar City Hospital, 34862 \u0130stanbul, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5725-0903","authenticated-orcid":false,"given":"Hasan Fehmi","family":"K\u00fc\u00e7\u00fck","sequence":"additional","affiliation":[{"name":"Kartal Dr. L\u00fctfi K\u0131rdar City Hospital, 34862 \u0130stanbul, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1007\/s12094-011-0613-1","article-title":"Gallbladder carcinoma incidentally encountered during laparoscopic cholecystectomy: How to deal with it","volume":"13","author":"Jin","year":"2011","journal-title":"Clin. 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