Biliary spillage a new prognostic factor in gallbladder cancer?

Gallbladder cancer is considered a rare disease associated with a dismal prognosis (1-3). However, since the irruption of laparoscopic cholecystectomy, incidental cases have increased and prognosis improved. The main reason for this improvement is the detection of unapparent tumors corresponding to mucosal and muscular lesions. Although laparoscopy has been associated with faster recovery and shorter hospital stay, the effect that gallbladder rupture and subsequent bile spillage on the prognosis of patients harboring an incidental gallbladder cancer is not completely understood (4,5).