Management of gallbladder polyps

Abstract

Objective. Appropriate treatment and timing hinge on whether the lesion is benign or malignant. Study: A five years retrospective descriptive analysis was performed. Location: Department of General Surgery in Hospitals of the University of Coimbra. Patients: We present a series of 93 consecutive patients who had elective surgery for known gallbladder polyps, treated from January 2003 to December 2007. Methods. An analysis was performed using clinical and radiological files of patients electively treated for gallbladder polyp. Ninety-three consecutive patients were evaluated, treated and followed in a Department of General Surgery in a Central Hospital in that period. Biographic, clinical and radiological data were compiled. Results. In 91 patients a benign lesion was found. Two (2.16%) patients had adenocarcinoma. Among benign polyps, 73 (78,5%) were cholesterol polyps, 14 (15%) were hyper-plastic and 2 (2.19%) were premalignant adenomas. Mean diameter of benign polyps, excluding adenomas, was 6 mm. In 40 (43%) patients, multiple lesions were found. The mean diameter in the subset of malignant and premalignant polyps was 18.8 mm, in all instances these were found to be single lesions; and mean age at presentation was 57,7 years. Conclusion. Cholecystectomy is the appropriate surgical treatment for gallbladder polyps, when removal is warranted. Patients benefit-ting from surgery are those who are symptomatic, whose polyps exceed 10 mm in diameter and, have shown to be enlarging, to be sessile or broad-based, to have long pedicles;and also have. infundibular polyps, coexisting gallstones or changes on the gallbladder wall appearance at ultrasonography.