Intracholecystic papillary neoplasms (ICPNs) are infrequent but significant preinvasive lesions associated with high-grade dysplasia and carcinoma.

• The pooled incidence of ICPNs is 1.5% in cholecystectomy cases.
• High-grade dysplasia occurs in 35.4% of ICPN lesions; 26.9% have concurrent adenocarcinoma.
• Lymph node metastases found in 18% of invasive cases, with 5-year survival rates varying from 46.7% to 89.7%.

Surgeons should consider these findings for better patient selection and surgical management to improve outcomes.