LAUSR

Editor We thank Li and colleagues for their interest in our recent study1. Today, the overwhelming majority of gallbladder cancer is discovered incidentally at centres without the capability to perform oncological extended resection (OER). Therefore, management of incidentally discovered gallbladder cancer must be distinguished between discovery at a centre with expertise in OER versus an institution without OER capabilities. Since timing to referral cannot be influenced by the receiving centre, articles such as the one presented here raise awareness that incidentally discovered or even suspicion of gallbladder cancer should prompt referral to a centre with expertise in OER. More specifically, as reported previously2, if gallbladder cancer is suspected intraoperatively and the expertise for OER is not present, the operation should be terminated. Further, in the work presented here, the 60-day interval was chosen based on our previous study demonstrating that patients with T2b incidental gallbladder cancer and a time interval between index cholecystectomy and OER of 60 days or more had a lower 3-year disease-specific survival rate compared to patients with T2b non-incidental gallbladder cancer (16 versus 85 per cent; P = 0⋅004)3. Patients with a longer time interval between index cholecystectomy and OER who received their index cholecystectomy at a participating (referral) centre, were older and more likely to have received