Retrospective Cohort Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Jul 27, 2025; 17(7): 106919
Published online Jul 27, 2025. doi: 10.4240/wjgs.v17.i7.106919
Bile spillage in incidental gallbladder cancer is not an independent predictor for survival: A multi-institute retrospective cohort study
Mike van Dooren, Elise AJ de Savornin Lohman, Rachel S van der Post, Frederik JH Hoogwater, Peter B van den Boezem, Bas Groot Koerkamp, Joris I Erdmann, Philip R de Reuver
Mike van Dooren, Elise AJ de Savornin Lohman, Peter B van den Boezem, Philip R de Reuver, Department of Surgery, Radboud University Medical Center, Nijmegen 6500 HB, Gelderland, Netherlands
Rachel S van der Post, Department of Pathology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Radboud University Medical Center, Nijmegen 6500 HB, Netherlands
Frederik JH Hoogwater, Department of Hepatobiliary and Transplant Surgery, University Medical Center Groningen, Groningen 9713 GZ, Netherlands
Bas Groot Koerkamp, Department of Surgery, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam 3015 GD, Netherlands
Joris I Erdmann, Department of Surgery, Cancer Center Amsterdam, University of Amsterdam, Amsterdam 1105 AZ, Netherlands
Co-corresponding authors: Mike van Dooren and Philip R de Reuver.
Author contributions: van Dooren M, de Savornin Lohman EAJ, de Reuver PR, van der Post RS, and van den Boezem PB contributed to the design of the study; van Dooren M and de Savornin Lohman EAJ collected and compiled data, performed analyses, and wrote the draft manuscript text; Erdmann JI, Hoogwater FJH, and Groot Koerkamp B were local principal investigators and collected data for their respective hospitals; de Reuver PR supervised the study; All authors and collaborators reviewed the manuscript.
Supported by Foundation ADP.
Institutional review board statement: This retrospective multicenter cohort study received approval from the Netherlands Cancer Registry ethical review board. An ethical approval waiver was granted by the Medical Ethics Review Committee of the region Arnhem-Nijmegen (number 2019-5521).
Informed consent statement: Due to the high mortality rate of gallbladder carcinoma, it was deemed not feasible to require informed consent from study participants by the institutional review board. Patient data was pseudonymized for the lead investigators.
Conflict-of-interest statement: The authors declare no conflicts of interest.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Data sharing statement: The dataset is available from the corresponding author at philip.dereuver@radboudumc.nl upon request. Consent was not obtained (as described in the informed consent statement), but the presented data were pseudonymized and the risk of identification is low.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Mike van Dooren, MD, Department of Surgery, Radboud University Medical Center, P.O. Box 9101, Internal Code 618, Nijmegen 6500 HB, Gelderland, Netherlands. mike.vandooren@radboudumc.nl
Received: March 11, 2025
Revised: April 7, 2025
Accepted: May 28, 2025
Published online: July 27, 2025
Processing time: 134 Days and 23.8 Hours
Core Tip

Core Tip: In this retrospective cohort study, the relationship between bile spillage and survival in patients with incidental gallbladder carcinoma was analyzed in 32 Dutch hospitals. Bile spillage was associated with adverse prognostic factors, namely higher age, American Society of Anesthesiologists classification, T stage, and non-radical resection. Unlike those other factors, bile spillage was not an independent predictor for survival in multivariable analysis. In our cohort bile spillage was linked to localized rather than peritoneal reoccurrence as described in existing literature. Patients with an indication for additional treatment should be referred to a specialized hepatopancreaticobiliary center, irrespective of whether bile spillage has occurred.