Incidental gallbladder cancer (IGBC) is often diagnosed post-cholecystectomy, making pre-op risk assessment crucial.

• Key predictors: advancing age (OR 1.09), female gender, elevated alkaline phosphatase, and larger gallbladder polyps increase IGBC risk.
• 788,214 patients analyzed from 18 studies reveal significant patterns for targeted evaluations.

Surgeons should integrate these factors into decision-making for better surveillance and patient outcomes.