Background: The aim of this retrospective study is to review our institutional experience with gallbladder cancer (GC). Specifically, the experience with incidental GC found on pathologic evaluation of laparoscopic cholecystectomy (LC) specimens and need for port site excision on definitive exploration.Methods: Patients diagnosed with gallbladder cancer (GC) from January 2005 to November 2008 were identified by diagnosis code in the hospital database and a case review was performed. Presentation, operative data, and pathology results were of particular interest in this review.Results: 24 cases were reviewed, 18 female and 6 male, with a mean age or 61 years (Range 29-87). The diagnosis of GC was established preoperatively in 1 case (palliative procedure), intra-operatively in 11, incidentally following pathologic examination of cholecystectomy (LC) specimens in 11 (45%), and liver explant in 1 (OTL). Of the cases of GC found post LC, 9 underwent exploration and radical resection (re-exploration with bile duct resection, segment 4b/5 liver resection, and lymphadenectomy) with intent to cure (81%), and 2 were explored and found unresectable (18%). Residual GC was found in 10 (91%). Port sites were excised in 9/11 explored patients (81%), all without evidence of carcinoma. 7/9 (78%) achieved negative margins with radical resection. 1/9 (11%) developed wound complications following port site excision, necessitating reoperation.Conclusions: GC is often found to be advanced and unresectible. The subgroup found on LC offer a higher potential for R0 resection with aggressive surgery (77% vs overall 37% in our experience), especially as 10/11 (91%) patients in this group had residual disease. None of the patients in this study had evidence of GC on port site excision, questioning the need for the procedure in the absence of gross disease.