Evidence map›Paper›PMID 30998534›Full record

ArticleAnnals of surgery2021

Adverse Outcomes After Bile Spillage in Incidental Gallbladder Cancers: A Population-based Study.

Michael J Horkoff, Zubir Ahmed, Yuan Xu, Francis R Sutherland, Elijah Dixon, Chad G Ball, Oliver F Bathe

Abstract read
PubMed Publisher
In one paragraph

Article in Annals of surgery, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers.

0numbers the graph read from it
0cells of the map it votes in
24citing papers in PubMed
5.1field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

24 citing papers in PubMed, 49 citations in OpenAlex.

  1. Article
  2. Review
  3. Article
  4. Review
  5. Incidental Gallbladder Cancer: A Comprehensive Review.Journal of gastrointestinal cancer · 2025
    Review
  6. Article
  7. Article
  8. Article
  9. Article
  10. Article
  11. Article
  12. Observational
  13. Review
  14. Article
  15. Review
  16. Article
  17. Article
  18. Article
  19. Article
  20. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors at 1 institution in 1 country.

Michael J HorkoffDepartment of Surgery, University of Calgary, Calgary, Alberta, Canada.
Zubir AhmedDepartment of Surgery, University of Calgary, Calgary, Alberta, Canada.
Yuan XuDepartment of Surgery, University of Calgary, Calgary, Alberta, Canada.
Francis R SutherlandDepartment of Surgery, University of Calgary, Calgary, Alberta, Canada.
Elijah DixonDepartment of Surgery, University of Calgary, Calgary, Alberta, Canada.
Chad G BallDepartment of Surgery, University of Calgary, Calgary, Alberta, Canada.
Oliver F BatheDepartment of Surgery, University of Calgary, Calgary, Alberta, Canada.
University of Calgary · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo determine the effect of bile spillage during cholecystectomy on oncological outcomes in incidental gallbladder cancers.

backgroundGallbladder cancer (GBC) is rare, but lethal. Achieving complete resection offers the best chance of survival. About 30% of GBCs are discovered incidentally after cholecystectomy for benign pathology. There is an anecdotal association between peritoneal dissemination and bile spillage during the index cholecystectomy. However, no population-based studies are available that measure the consequences of bile spillage on patient outcomes.

methodsWe conducted a retrospective cohort comparison of patients with incidental GBC. All cholecystectomies and cases of GBC in Alberta, Canada, from 2001 to 2015, were identified. GBCs discovered incidentally were included. Operative events leading to bile spillage were reviewed. Patient outcomes were compared between cases of bile spillage versus no contamination.

resultsIn all, 115,484 cholecystectomies were performed, and a detailed analysis was possible in 82 incidental GBC cases. In 55 cases (67%), there was bile spillage during the index cholecystectomy. Peritoneal carcinomatosis occurred more frequently in those with bile spillage (24% vs 4%; P = 0.0287). Patients with bile spillage were less likely to undergo a radical re-resection (25% vs 56%; P = 0.0131) and were less likely to achieve an R0 resection margin [odds ratio 0.19, 95% confidence interval (CI) 0.06-0.55]. On Cox regression modeling, bile spillage was an independent predictor of shorter disease-free survival (hazard ratio 1.99, 95% CI 1.07-3.67).

conclusionFor incidentally discovered GBC, bile spillage at the time of index cholecystectomy has measureable adverse consequences on patient outcomes. Early involvement of a hepatobiliary specialist is recommended where concerning features for GBC exist.

Indexed as

BileCholecystectomyIncidental FindingsAgedAged, 80 and overFemaleGallbladder NeoplasmsHumansMaleMiddle AgedNeoplasm SeedingPostoperative ComplicationsRetrospective StudiesTreatment Outcome

Identifiers

PMID30998534
OpenAlexW2942055971

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.