Role of Cystic Lymph Nodes in Incidental Gallbladder Cancer: Implications for Routine Excision and the Sentinel Lymph Node Concept

Gallbladder cancer (GBC) is a rare but aggressive malignancy, often diagnosed incidentally after or even during routine cholecystectomy for presumed benign conditions, the commonest being gallstone disease (GSD) - this is incidental GBC (iGBC). The involvement of cystic lymph nodes (CLNs), which are located near the cystic artery and the cystic duct, has been an area of clinical interest in predicting the prognosis, staging, and therapeutic decision-making of GBC. This review explores the significance of CLN status in iGBC, evaluates the potential benefits of routine CLN excision during simple cholecystectomy, and explores the applicability of the sentinel lymph node (SLN) concept in the management of iGBC.