BackgroundPreoperative high blood glucose levels are closely associated with poor performance and high mortality in cancer patients. This study was designed to investigate the relationship between preoperative fasting hyperglycemia and the prognosis of patients with gallbladder cancer (GBC) after undergoing GBC radical surgery.Patients and methodsA retrospective analysis of 83 eligible patients who underwent GBC radical surgery between 2007 and 2016 was performed. Factors affecting overall survival (OS) and recurrence-free survival (RFS) were analyzed by univariate and multivariate analyses.ResultsOf the 83 patients, 35 (42.2%) had preoperative fasting hyperglycemia. The median OS of the enrolled patients was 12 months. The median OS in patients with fasting hyperglycemia before surgery was 18 months, which was shorter than for patients with normal fasting blood glucose levels before surgery (47 months, P<0.001). Preoperative fasting hyperglycemia was associated with shorter survival times in univariate analyses (HR, 3.215; 95% CI, 1.846–5.601; P<0.001). Multivariate analysis showed that patients with preoperative fasting hyperglycemia had a lower OS (HR, 2.832; 95% CI, 1.480–5.418; P=0.002) and RFS (HR, 2.051; 95% CI, 1.127–3.733; P=0.019) than patients with normal preoperative fasting blood glucose levels.ConclusionPreoperative fasting hyperglycemia is an independent indicator of poor prognosis in GBC patients after GBC radical surgery.