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Pooling individual records from more than 2,000 patients, the timing of the second operation for chance-found gallbladder cancer made no measurable difference to survival, and studies did not even agree on what early or late meant.
Systematic review (four databases to 10 October 2025; PROSPERO CRD42023453990) of 12 retrospective studies with 2,067 patients (566 men, 1,346 women) reporting outcomes by timing of revision surgery. There was no consensus on definitions of early, intermediate and delayed surgery. Successful revision, perioperative morbidity and R0 rates were similar across timing groups. Individual patient data meta-analysis found no difference in overall survival by timing (hazard ratio 1.29, 95 percent CI 0.79 to 2.10 for the comparison reported). Most studies scored 7 to 8 of 10 on the JBI tool.
It softens the Ethun four-to-eight-week rule: timing within the range that services can deliver probably matters less than completing the operation at all and doing it with the liver bed and nodes cleared.
Shares A national incidental gallbladder cancer pathway: histology for every gallbladder, referral within two weeks, re-resection by eight, Incidental gallbladder cancer (found after cholecystectomy), Radical (extended) cholecystectomy, Gallbladder cancer roadmap: from a chance finding at gallstone surgery to a disease with its own trials and the tag gallbladder-evidence.
Shares Incidental gallbladder cancer (found after cholecystectomy), Radical (extended) cholecystectomy, Gallbladder cancer roadmap: from a chance finding at gallstone surgery to a disease with its own trials, Gallbladder cancer and the tag gallbladder-evidence.
Shares A national incidental gallbladder cancer pathway: histology for every gallbladder, referral within two weeks, re-resection by eight, Incidental gallbladder cancer (found after cholecystectomy), Gallbladder cancer and the tag gallbladder-evidence.
Shares A national incidental gallbladder cancer pathway: histology for every gallbladder, referral within two weeks, re-resection by eight, Incidental gallbladder cancer (found after cholecystectomy), Radical (extended) cholecystectomy, Gallbladder cancer roadmap: from a chance finding at gallstone surgery to a disease with its own trials and the tag gallbladder-evidence.
Shares Incidental gallbladder cancer (found after cholecystectomy), Radical (extended) cholecystectomy, Gallbladder cancer roadmap: from a chance finding at gallstone surgery to a disease with its own trials, Gallbladder cancer and the tag gallbladder-evidence.
Shares Incidental gallbladder cancer (found after cholecystectomy), Radical (extended) cholecystectomy, Gallbladder cancer roadmap: from a chance finding at gallstone surgery to a disease with its own trials, Gallbladder cancer and the tag gallbladder-evidence.
Shares Incidental gallbladder cancer (found after cholecystectomy), Gallbladder cancer roadmap: from a chance finding at gallstone surgery to a disease with its own trials, Gallbladder cancer and the tag gallbladder-evidence.
Shares Incidental gallbladder cancer (found after cholecystectomy), Radical (extended) cholecystectomy, Gallbladder cancer roadmap: from a chance finding at gallstone surgery to a disease with its own trials, Gallbladder cancer and the tag gallbladder-evidence.