Background: Gallbladder carcinoma (GBC) is an aggressive hepatobiliary malignancy with a disproportionately high incidence in northern and north-eastern India. Most patients present at an advanced, often unresectable stage, so surgical resection—when feasible—remains the only potentially curative treatment.

Aim: To describe the surgical management patterns of patients operated for carcinoma gallbladder at a tertiary care centre in North-East India over a three-year period.

Materials and Methods: A retrospective, single-department review of the operation theatre log register was performed for all patients undergoing surgery for histologically or radiologically diagnosed carcinoma gallbladder between January 2023 and December 2025. Demographic details, year of surgery, operating surgeon, and procedure performed were extracted and tabulated. Data were analysed descriptively.

Results: Twenty-eight patients underwent surgery for carcinoma gallbladder (2023: n=4; 2024: n=9; 2025: n=15), showing a rising year-on-year caseload. The cohort was predominantly female (21/28, 75%) with a mean age of 56.1 ± 12.0 years (range 29–76 years); the highest concentration of cases occurred in the sixth decade of life. Curative-intent resection (primary or completion radical cholecystectomy, with or without extended organ resection or bilio-enteric reconstruction) was achieved in 11 of 28 patients (39.3%). The remainder underwent simple/completion cholecystectomy without formal radical clearance (9, 32.1%), exploratory laparotomy with or without palliative bypass (4, 14.3%), diagnostic laparoscopy/ laparotomy (2, 7.1%), isolated palliative bypass (1, 3.6%), or simple open cholecystectomy (1, 3.6%). Two operating Surgeons performed the majority of procedures (82.1% and 17.9% of cases respectively).

Conclusion: Carcinoma gallbladder continues to present predominantly in an advanced or incidentallydetected form in this region, so that curative-intent resection was possible in fewer than two out of every five operated patients. A rising annual caseload, together with the frequency of incidental postcholecystectomy referrals, underscores the need for heightened preoperative suspicion, wider access to cross-sectional imaging, and structured referral pathways to high-volume hepatobiliary units.

KEYWORDS: Carcinoma Gallbladder, Radical Cholecystectomy, Completion Cholecystectomy, Palliative Surgery, Hepatobiliary Malignancy, North-East India, Retrospective Study.