To investigate the diagnosis and treatments of incidental gallbladder cancer (IGBC).

Clinical data of 27 IGBC patients undergoing laparoscopic cholecystectomy (LC) in Gansu Provincial Hospital from January 2013 to March 2018 were retrospectively analyzed. Among them, 4 patients were male and 23 female, aged from 38 to 83 years with a median age of 62 years. 24 patients were diagnosed with gallbladder stones and 3 cases of gallbladder polyp before oprtation. The informed consents of all patients were obtained and the local ethical committee approval was received. The clinical characteristics, diagnosis and treatments of IGBC were analyzed. Survival analysis was performed by Log-rank test.

A total of 6 585 patients underwent LC in the same period, and IGBC accounted for 0.41% (27/6 585). 3 cases were diagnosed with IGBC during the operation and 24 cases after the operation. Among them, 7 cases were diagnosed with IGBC Tis stage, and 3 with T1b, 4 with T2a, 12 with T3 and 1 with T4. The 3 patients who were diagnosed during the operation underwent radical resection of IGBC simultaneously and 10 cases received radical resection of IGBC in secondary operation. The median survival time of patients with Tis, T1, T2 and (T3+T4) stage IGBC was 45, 45, 13 and 9 months, respectively. The median survival time of patients undergoing radical resection and non-radical resection was 32 and 17 months. The survival time significantly differed between patients with different tumor stages and surgical approach (χ²=21.061 4.440; P<0.05).

Intraoperative pathological examination contributes to early detection of IGBC, provides an opportunity to optimize the primary surgical plan and avoids the secondary operation. Clinical prognosis of IGBC patients is significantly correlated with surgical approach and pathological stage.