Surgeons can now better identify patients who may not benefit from surgery for gallbladder cancer.

• 11.1% of patients experienced ‘futile surgery’ with a median survival of only 8.9 months.
• Those who received successful surgical intervention had a median survival of 88.7 months (p < 0.001).

Incorporating this nomogram into preoperative decision-making may significantly reduce unnecessary procedures.

• Key predictors include elevated CA 19-9 levels, borderline resectable status, and the need for extended resections.