Objective: The nature of the polypoid lesions of the gallbladder is difficult to determine preoperatively and indications for surgical treatment still remain controversial. The aim of this study is to review the clinicopathological features of patients with gallbladder polyps.
Material-Method: Patients with preoperative diagnosis of gallbladder polyp, between January 1995 and June 2003, were evaluated retrospectively according to their demographic findings, clinical symptoms, abdominal ultrasonographical features, type of surgical treatment and postoperative pathological results.
Results: Among 1120 patients who underwent cholecystectomy, 25 had preoperative diagnosis of gallbladder polyps by abdominal ultrasonography (2.3%). The most common symptom was abdominal pain resembling biliary colic, existing in all 25 patients. Ultrasonography revealed immobile polypoid lesion attached to the mucosal surface, having posterior acoustic shadow in all cases. Polyps were defined as sessile in 22 (88%) patients and pedunculated in 3 (12%). Co-existing gallbladder stone was detected in 7 patients with abdominal ultrasonography (28%). Cholecystectomy was performed laparoscopicaly in 18 patients and open technique was used for the first 7 patients. Histopathological examination revealed cholesterol polyps in 9 patients (36%), adenoma in 2 (8%) and gallbladder adenocarcinoma in 1 case (4%). Pathological diagnoses were chronic cholecystitis with gallbladder stones in 13 cases (52%) which were thought to be polyps under ultrasonographical examination.
Conclusion: Preoperative assessment of gallbladder polyps is a challenging issue for both radiologists and surgeons. Once gallbladder polyp is detected and diagnosed surgery is the choice of treatment in all symptomatic cases, when polyp size is greater than 10mm and in patients older than 50 years of age due to the risk of malignancy.
Program Number: P397