Background : Distinguishing between gallbladder cancer (GBC) and GB cancer mimicking cholecystitis remains a clinical challenge due to their shared clinical and radiological features. Accurate preoperative differentiation is crucial for guiding appropriate surgical management.

Methods : This retrospective study, conducted at Keimyung University Dongsan Hospital from 2008 to 2023, aimed to assess the role of preoperative biopsy in diagnosing GBC and differentiating it from GB cancer mimicking cholecystitis. Among 55 initially suspected cases, 17 benign cases were excluded, focusing the analysis on the remaining 38 cases to evaluate the impact of preoperative biopsy on surgical decision-making.

Results : Of the 38 cases, 29 patients underwent preoperative biopsy, while 9 did not. The biopsy group showed a significantly lower rate of unnecessary surgeries, with only 1 out of 29 cases (3.4%) undergoing such procedures. In contrast, the non-biopsy group had a markedly higher rate, with 7 out of 9 cases (77.8%) undergoing unnecessary surgeries, including 4 cases identified as benign during intraoperative frozen section biopsies. Statistical analysis revealed a significant difference (p=0.0000163) between the two groups.

Conclusions : This study underscores the importance of preoperative biopsy in differentiating GBC from GB cancer mimicking cholecystitis. The findings advocate for the routine use of preoperative biopsy in surgical decision-making for these complex gallbladder pathologies. Implementing preoperative biopsy can significantly reduce the incidence of unnecessary surgeries, leading to improved patient care and more efficient utilization of medical resources. These results have significant implications for surgical practices worldwide, emphasizing the necessity of comprehensive preoperative evaluation in optimizing patient outcomes.