Introduction: Early gallbladder cancer (GBCA) is often discovered incidentally with cholecystectomy for presumed benign disease. While additional radical resection is currently recommended for pT1b+ disease, other risk factors for residual disease are poorly defined and the indication for such operation remained yet to be optimized. The study aims were to evaluate the histopathologic variables associated with risk of lymph node metastasis, and to identify the low-risk group who can spare additional surgery.