Prophylactic cholecystectomy in benign gallbladder disease as a preventive measure for gallblader cancer: Is there any impact?

Benign gallbladder disease (BGD), namely cholelithiasis and chronic cholecystitis, pose a significant public healthcare problem given their impact on morbimortality and healthcare costs. Furthermore, cholelithiasis and chronic cholecystitis are the most frequent risk factors for developing gallbladder cancer (GBC), a condition that is often incurable at diagnosis due to delayed symptomatology; thus further contributing to the burden of morbidity and mortality. In light of this panorama, some healthcare systems began to adopt prophylactic cholecystectomy (PCH) as a preventive measure in patients diagnosed with BGD, aiming to reduce the potential development of GBC, as well as the need for recurrent consultation to the emergency room due to complications. Indeed, implementing a preventive surgical strategy, particularly in regions with higher incidence of GBC, has become a topic for active discussion and continuous exploration. Evidence regarding PCH and its related benefits is emerging globally, with varied results and perspectives depending on local epidemiology and healthcare resources. As expected, studies across different populations reveal disparities in GBC rates as well as disparities regarding PCH outcomes and benefits. The great heterogeneity within the available data sets the ground for debate on the efficacy and advisability of this preventive approach. This review aims to analyze the impact of PCH on cancer incidence and mortality, adjusting for different populations and making a contrast between the pros and cons of this measure.