Abstract
OBJECTIVE: To systematically review the latest evidence on risk factors and surgical treatment for gallbladder cancer (GBC), with a focus on current controversies and consensus in international guidelines, analyze the application prospects of minimally invasive surgery in advanced GBC, and provide direction for clinical practice and future research. METHODS: Literature on GBC risk factors, molecular mechanisms, and treatment strategies published from 2018 to 2024 was retrieved from databases including PubMed, Web of Science, and CNKI. The retrieved literature was summarized, compared, and critically analyzed. RESULTS: The pathogenesis of GBC involves a combination of genetic, environmental, and metabolic factors. Beyond gallstones and polyps, mutations in TP53 and ERBB2/ERBB3 genes, metabolic syndrome (obesity, hyperglycemia, hyperlipidemia), and chronic infections (Salmonella, Helicobacter) are significant risk factors. Surgical resection remains the primary curative approach, yet the optimal extent of surgery is debated: Is hepatic resection always necessary for T1b stage? What is the oncological safety of laparoscopic surgery for T2 stage? What is the value of extended resection for T4 stage? Recently, targeted therapies (e.g., against ERBB2, NTRK) and mmune checkpoint inhibitors (anti-PD-1/PD-L1)have shown promise in advanced GBC. CONCLUSION: Combating GBC requires a comprehensive strategy encompassing health education, screening of high-risk populations, precise staging, and individualized multimodal treatment. Future research should focus on building molecular subtype-based prognostic models, conducting high-level clinical studies to resolve surgical controversies, and exploring the integration of novel adjuvant therapies with traditional surgery.