GALLBLADDER POLYPS: FACTORS AFFECTING SURGICAL DECISION.

Abstract

AIM: To determine the factors affecting the decision to perform surgery, and the efficiency of ultrasonography (USG) in detecting gallbladder polyps (GP).

METHODS: Data for 138 patients who underwent cholecystectomy between 1996 and 2012 in our clinic with a diagnosis of GP were retrospectively analyzed. Demographic data, clinical presentation, principal symptoms, ultrasonographic and histopathological findings were evaluated. Patients were evaluated in individual groups according to the age of the patients (older or younger than 50 years old) and polyp size (bigger or smaller than 10 mm) and characteristics of the polyps (pseudopolyp or real polyps). χ2  tests were used for the statistical evaluation of the data.

RESULTS: The median age was 50 (26-85) years and 91 of patients were female. Of 138 patients who underwent cholecystectomy with GP diagnosis, only 99 had a histopathologically defined polyp; 77 of them had pseudopolyps and 22 had true polyps. Twenty-one patients had adenocarcinoma. Of these 21 patients, 11 were male, their median age was 61 (40-85) years and all malignant polyps had diameters > 10 mm (P< 0.0001). Of 138 patients in whom surgery were performed, 112 had ultrasonographic polyps with diameters < 10 mm. Of the other 26 patients who also had polyps with diameters > 10 mm, 22 had true polyps. The sensitivity of USG was 84.6% for polyps with diameters > 10 mm (P < 0.0001); however it was only 66% in polyps with diameters < 10 mm.

CONCLUSION: The risk of malignancy was high in the patients over 50 years old who had single polyps with diameters >10 mm.

 

Core tip: Early stage gallbladder cancers can often be detected as polyps in imaging studies. The aim of this study was to determine the factors affecting surgery by analyzing the incidence of malignancy of gallbladder polyps (GP) and the efficiency of ultrasonography in detecting GP. Of 138 patients with GP on imaging, 99 had polyps and 21 had histopathologically confirmed adenocarcınoma. Of these 21 patients, all malignant polyps were solitary and had a diameter >10 mm. In our study, the risk of malignancy correlated wıth age over 50 years old, solitary polyp and polyp diameter >10 mm.

 

Key words: Gallbladder; Polyps; Ultrasound; Cholecystectomy; Malignancy

 

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