REVIEW Incidental gallbladder cancer: what management? Sidi Mohammed Bouchentouf • Soundouss Raissouni • Ibrahima Sall • Hakim El Kaoui • Hicham Baba • Ahmed Bounaim • Abdelmounim Ait Ali • Khalid Sair • Aziz Zentar Received: 20 July 2011 / Accepted: 6 October 2011 / Published online: 29 October 2011 Ó Springer-Verlag 2011 Abstract Gallbladder cancer (GBC) represents 3.8% of all gastrointestinal cancers and usually known to be of a poor prognosis. In 0.2–2.9% of cases, this cancer is found in cholecystectomy specimens. A better understanding of spread mode of this tumor helps a better surgical man- agement. The aim of the present review is to underline the management of GBC based on the comprehension of risk factors and anatomic features. A Medline, PubMed data- base search was performed to identify articles published from 2000 to 2011 using the keywords ‘carcinoma of gallbladder’, ‘incidental gallbladder cancer’, ‘gallbladder neoplasm’ and ‘cholecystectomy’. Some pathological sit- uations such as chronic lithiasis and biliopancreatic junc- tion abnormalities have been clearly identified as predisposing to GBC. Laparoscopy increases peritoneal and parietal tumor dissemination, thus, it should not be performed when GBC is suspected. Most determinant prognostic factors are nodal, perineural and venous involvement, invasion of the cystic duct and the tumor differentiation. The simple cholecystectomy is sufficient for tumors classified as T1a; for other cancers exceeding the muscularis, radical re-resection is required due to the high risk of recurrence. This aggressive surgery improved the overall survival of patients. There is still no standard adjuvant treatment; patients should be included in pro- spective trials. Keywords Gallbladder cancer Á Laparoscopy Á Re-resection Introduction Cholecystectomy is the most frequent procedure performed in digestive surgery departments. It accounts 1 million procedures per year worldwide. The incidence of gall- bladder cancer (GBC) is 3.8% of all digestive cancers and it varies according to regions. 1.3–5% is discovered inci- dentally when performing cholecystectomy for benign lesions [1–4]. Gallbladder cancer is known to be of a poor prognosis, however, the prognosis of GBC discovered incidentally is better than that found pre-operatively [5, 6]. Over the past decade, the management of GBC dis- covered incidentally is more codified. Surgery depends on the stage; when well indicated, it helps improve the prognosis. The aim of the present review is to underline the management of GBC based on the comprehension of risk factors and anatomic features. Method A Medline, PubMed database search was performed to identify articles published from 2000 to 2011 using the keywords ‘carcinoma of gallbladder’, ‘incidental gall- bladder cancer’, ‘gallbladder neoplasm’ and ‘cholecystec- tomy’. Relevant articles including review articles, clinical and basic research articles were included. Additional arti- cles were identified by a manual search of the references from the key articles. Conclusions are made according to evidence based medicine. S. M. Bouchentouf (&) Á I. Sall Á H. E. Kaoui Á H. Baba Á A. Bounaim Á A. A. Ali Á K. Sair Á A. Zentar Hopital Militaire d’instruction Mohammed V, Rabat, Morocco e-mail: smbouchentouf@hotmail.com S. Raissouni National Oncology Institute, Rabat, Morocco 123 Oncol Rev (2011) 5:241–247 DOI 10.1007/s12156-011-0092-1