Present status of surgical diagnosis and treatment of incidental gallbladder cancer

The incidental gallbladder cancer (IGBC) is defined as the gallbladder cancer, which is diagnosed during or following cholecystectomy by pathological examinations, preoperatively considered as benign gallbladder disease. IGBC is usually not associated with readily discernible clinical signs and combined with other benign lesions. And the early clinical manifestations are usually non-specific. It is more difficult to diagnosis before operation. With the extensive operation of laparoscopic cholecystectomy, the patients with IGBC have increased. Modern imageology can improve the preoperative diagnosis of gallbladder cancer and reduce the incidence of IGBC. TNM staging system (AJCC 8th) for gallbladder cancer has an important guiding significance for treatment selection and prognosis of IGBC. Comprehensive treatment based on radical surgery is the most effective therapeutic option for IGBC. Secondary radical surgery appears to have a clear therapeutic effect in T2 and T3 patients with IGBC. Single surgical approach does not apply to the patients with IGBC in each stage, and the specific surgical approach should be based on TNM staging. Chemotherapy and radiotherapy has achieved certain results in the case of IGBC, but the overall effect is not satisfactory. There is a lack of attention to the research on IGBC at present. Clinically, there is still a lack of effective guidelines to treat IGBC, and the standard surgical regimens for IGBC remained controversial. In this paper, the authors give a brief overview of the research progress and doubtful points in the treatment of IGBC.