{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T05:10:02Z","timestamp":1764047402024,"version":"3.41.2"},"reference-count":29,"publisher":"Baishideng Publishing Group Inc.","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World J Gastrointest Surg"],"abstract":"<jats:p>BACKGROUND<\/jats:p>\n          <jats:p>Bile spillage occurs more frequently in patients with incidental gallbladder carcinoma (iGBC) and may be associated with poor survival due to presumed high risk of peritoneal seeding.<\/jats:p>\n          <jats:p>AIM<\/jats:p>\n          <jats:p>To investigate the impact of bile spillage during primary surgery on the survival of patients with iGBC.<\/jats:p>\n          <jats:p>METHODS<\/jats:p>\n          <jats:p>Medical records of patients with iGBC diagnosed between 2000 and 2019 in 27 Dutch secondary centers and 5 tertiary centers were retrospectively reviewed. Patient medical records were assessed. Predictors for overall survival (OS) were determined using multivariable Cox regression.<\/jats:p>\n          <jats:p>RESULTS<\/jats:p>\n          <jats:p>Of the 346 included patients with iGBC, 138 (39.9%) had bile spillage, which was associated with higher American Society of Anesthesiologists classification (P  = 0.020), cholecystitis (P  &lt; 0.001), higher tumor stage (P  = 0.005), and non-radical resection (P  &lt; 0.001). Bile spillage was associated with poor OS [hazard ratio = 1.97, 95% confidence interval (CI): 1.48\u20132.63, P  &lt; 0.001] with a median OS of 12 months (95%CI: 7-18 months) vs  34 months (95%CI: 14\u201355 months, P  &lt; 0.001). In multivariable analysis, spillage was not an independent prognostic factor for survival (hazard ratio = 1.21, 95%CI: 0.84-1.74, P  = 0.313).<\/jats:p>\n          <jats:p>CONCLUSION<\/jats:p>\n          <jats:p>Although bile spillage correlates with prognostic factors, it lacks independent prognostic significance for survival. Patients with an indication for additional treatment should be promptly referred to a specialized hepatopancreatobiliary center, irrespective of whether bile spillage has occurred.<\/jats:p>","DOI":"10.4240\/wjgs.v17.i7.106919","type":"journal-article","created":{"date-parts":[[2025,7,22]],"date-time":"2025-07-22T14:23:55Z","timestamp":1753194235000},"source":"Crossref","is-referenced-by-count":1,"title":["Bile spillage in incidental gallbladder cancer is not an independent predictor for survival: A multi-institute retrospective cohort study"],"prefix":"10.4240","volume":"17","author":[{"given":"Mike van","family":"Dooren","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elise AJ","family":"de Savornin Lohman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachel S","family":"van der Post","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frederik JH","family":"Hoogwater","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter B","family":"van den Boezem","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bas","family":"Groot Koerkamp","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joris I","family":"Erdmann","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philip R","family":"de Reuver","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2060","published-online":{"date-parts":[[2025,7,27]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)00153-7"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1016\/j.suc.2014.01.009"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1177\/000313481708300721"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-019-08074-4"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1186\/s12957-022-02880-z"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2016.3642"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.21037\/cco.2019.07.01"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1016\/S0039-6060(98)70005-4"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1007\/s002689900613"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1007\/s005340100022"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1007\/s00534-006-1187-0"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1002\/jso.26569"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000003325"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2007.11.008"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1155\/2007\/971816"},{"key":"B16","unstructured":"Hendrix JM, Garmon EH.   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