Surgical Indications in Gallbladder Polyps

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• 作者：Francisco Jos茅 Morera-Oc贸n ; Javier Ballest铆n-Vicente ; Ana Mar铆a Calatayud-Blas ; Leonardo Cataldo de Tursi-Rispoli ; Juan Carlos Bernal-Sprekelsen
• 关键词：Gallbladder polyp ; Pseudopolyp ; Adenoma ; Adenocarcinoma ; Cholecystectomy
• 刊名：Cirug篓陋a Espa?ola (English Edition)
• 出版年：May, 2013
• 年：2013
• 卷：91
• 期：5
• 页码：324-330
• 全文大小：1791 K

文摘

Introduction

The surgery of gallbladder polyps is not well defined due to the lack of evidence-based clinical guidelines.

Objective

To analyze the management of polyps in Spain, and a review of the literature and treatment standards.

Material and methods

The reports on cholecystectomy with gallbladder polyps (GBP) were extracted from the Pathology data base. Patients subjected to surgery with a diagnosis of GBP were identified in the Surgery data base. A single list was prepared and a review was made of the clinical histories, including, age, gender, clinical data, ultrasound report, and histopathology report.

Results

A total of 30 patients, with a median age of 51 years (range 22-83), 21 of whom were female, were included. The ultrasound diagnosis was GBP in 19 patients, GBP and calculi in 7 cases, and calculi with no polyps in 4 cases. Other diagnoses concurrent with GBP were multiple haemangiomas (3), large single simple cyst (1), and multiple simple cysts (1). Eleven patients had typical pain (biliary origin), 5 of which showed no calculi on ultrasound. Eight had non-specific pain, which persisted in 3 cases after the cholecystectomy. Pseudopolyps were found in 20 gallbladders, and true polyps in 4 cases. In 3 cases, polyps were not found in the pathology study.

Conclusions

The ultrasound report must specify the size, shape, and number of polyps. Patients with biliary type pain would benefit from a cholecystectomy. The probability of malignancy is minimum if the GBP is less than 10 mm and aged under 50 years, and a cholecystectomy is not required. A GBP greater than 10 mm should be an indication of cholecystectomy.