A Useful Approach to the Differential Diagnosis of Small Polypoid Lesions of the Gallbladder, Utilizing an Endoscopic Ultrasound Scoring System

Sadamoto, Yojiro; Oda, Shigeto; Tanaka, Munehiro; Harada, Naohiko; Kubo, Hiroaki; Eguchi, Takashi; Nawata, Hajime

doi:10.1055/s-2002-35859

Cited by 94 publications

(77 citation statements)

References 15 publications

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“…There are several studies that endoscopic ultrasonography (EUS) has improved accuracy of the differential diagnosis of GB polyps. 6,7,9,27,28 Since this was a retrospective study, some of the patients underwent EUS and we could not evaluate as uniform diagnostic modalities. However, there are many common factors that could predict malignant GB polyps.…”

Section: Discussionmentioning

confidence: 99%

“…28 In addition, Sadamoto et al reported that size (＞10 mm), heterogenous internal echo pattern and the absence of hyperechoic spots are suggesting factors of malignancy. 6 Several studies have tried to identify predictors of malignant GB polyps for early detection of GB cancer. As summarized in Table 3, 25 malignant GB polyp patients revealed as early stage GB cancer (4: stage 0, 8: IA, 9: IB, 1: IIA, and 3: IIB).…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, the differentiation of precancerous lesions and earlier GB carcinoma originating from a GB polyp is essential for proper treatment. [6][7][8][9] Currently, surgical removal is recommended for GB polyps sized ＞1 cm in view of the higher risk of malignancy, 5,10-14 whereas patients with a smaller polyp usually require repeated USG and follow-up. It causes a certain degree of anxiety to the patient, and presents a considerable cost burden to the health care system.…”

Section: Introductionmentioning

confidence: 99%

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Management Strategies for Gallbladder Polyps: Is It Possible to Predict Malignant Gallbladder Polyps?

Park

Yoon²,

Kim³

et al. 2008

Gut Liver

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Background/Aims: Gallbladder (GB) polyps are commonly encountered in clinical practice, and are found more frequently as the number of medical screening examinations increases. The aim of this study was to determine optimal practice guideline for surgical treatment and follow-up of GB polyps. Methods: Data from healthy subjects of Seoul National University Hospital (SNUH) Health Care System of Gangnam Center were used to investigate the true prevalence of GB polyps. We also enrolled 689 patients with GB polyps diagnosed at SNUH from The GB polyp prevalence was 6.1% (7.1% in males and 4.8% in females). The median follow-up duration in the 689 study patients was 60 months, and 139 (20%) of them had polyps ≥10 mm in size. Twenty-five of the 180 patients who underwent cholecystectomy had adenocarcinomas. The χ 2 test was used to identify which of the following were risk factors of malignancy: age, sex, symptoms, size, rate of growth, multiplicity, accompanying stones, and shape. Age (≥57 years), presence of symptoms, size (≥10 mm), and shape (sessile) were found to be statistically significant risk factors by univariate analysis. However, multivariate analysis identified only age (≥57 years) and size (≥10 mm) as independent predictors of malignancy. Conclusions:The present study shows that GB polyps ≥10 mm in size in patients aged ≥57 years are the independent factors predicting malignancy of the GB. (Gut and Liver 2008;2:88-94)

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Management Strategies for Gallbladder Polyps: Is It Possible to Predict Malignant Gallbladder Polyps?

Park

Yoon²,

Kim³

et al. 2008

Gut Liver

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“…According to EUS scoring system, the sensitivity, specificity, and accuracy for the risk of neoplastic polyps with scores of 12 or higher were 78%, 83%, and 83%, respectively. [28] …”

Section: Eus Scoring Systemmentioning

confidence: 99%

Laparoscopic Management of Gall Bladder Polyp

Gajbhiye¹,

Raj²,

Surana³

2014

IOSRJDMS

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“…Safra kesesi poliplerine, ya insidental olarak ya da safra kesesi taşına benzer semptomlarla tanı konmaktadır (5). USG ile beraber endoskopik ultrasonografi kullanımının yaygınlaşması ile polip tanısında artış izlenmiştir (6,7). Safra kesesi poliplerinin büyük çoğunluğunu kolesterol polipleri oluşturur ve malignite potansiyeli taşımazlar (8).…”

Section: Introductionunclassified

Our surgical experience in gall bladder polyps

Dinç¹,

Çoşkun²,

Küçük³

2013

Gaziantep Med J

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ÖzetÇalışma; Ankara Numune Eğitim ve Araştırma Hastanesi 3. Genel Cerrahi Kliniğine, Mayıs 2005 ile Haziran 2011 tarihleri arasında safra kesesi polibi tanısı almış, verilerine ulaşılan 59 hastadan opere edilen 35 hastanın retrospektif analizini içermektedir. Klinikte safra kesesi polibi tanısı ile opere edilen 35 hastanın 21'i (%60) kadın; 14'ü (%40) erkekti. Ortalama yaş 47.1 idi. Tüm olgularda radyolojik tetkik olarak ultrasonografi kullanıldı. Hastaların preoperatif dönemde yapılan ultrasonografilerinde; 14 (%40) olguda tek polip; 7 (%20) olguda multipl polip; 13 (%37.2) olguda polip ve safra kesesi taşı; 1 (%2.8) olguda malignite açısından şüpheli bulgulara rastlandı. Otuz beş hastadan; 32'sine (%91.5) laparoskopik kolesistektomi, 3'üne (%8.5) ise açık kolesistektomi uygulanmıştır. Hitopatolojik incelemede; 19 hastada kollesterol polibi; 13 hastada kolesterol polibi + kolelitiazis, 1 hastada adenomatöz polip, 1 hastada safra kesesi adenokanseri saptanmıştır. Polip tanısı ile opere edilen 1 hastanın patolojik incelemesinde polip saptanmamış ve safra kesesi duvarına yapışık 1 adet safra taşı izlenmiştir. Sonuç olarak, semptomatik olmasa bile 50 yaş üzerinde, polip boyutu 10 mm üzerinde olan, kolelitiazis ile birlikte olan olgularda malignite ihtimali olduğundan dolayı cerrahi tedavi uygulanmalıdır. Bunların dışında 10 mm'nin altında olan olgular 6 aylık periyotlarla ultrasonografi izlem programına alınmalıdırlar. Bu zaman zarfında polip boyutlarında büyüme, polip sayılarında artış olursa, semptomlar gelişirse cerrahi tedavi gündeme getirilmelidir. rd Department of General Surgery. In this period 59 patients were diagnosed by gallbladder polyps, but only 35 of them were operated. Twenty one of 35 patients who were operated in our clinic with the diagnosis of gallbladder polyps, were female (%60) and 14 were male (40%). The mean age was 47.1. In all cases, ultrasound is used as a radiological examination. According to the preoperative ultrasonography reports of the patients; in 14 (40%) cases there was a single polyp, in 7 (20%) cases there were multiple polyps, in 13 (37.2%) cases there were polyps and gallstones and in 1 (2.8%) case his findings were suspicious for malignancy. We performed laparoscopic cholecystectomy to 32 (91.5%) of 35 patients and 3 patients (8.5%) were performed open cholecystectomy. According to histopathological examination, cholesterol polyps in 19 patients, cholesterol polyps + cholelithiasis in 13 patients, adenomatous polyp in one patient, and adenocarcinoma of the gallbladder in one patient were found. During the pathological examination of a patient who was operated with the diagnosis of polyp; there was no polyp detected, and a gallstone adherent to the gallbladder wall was observed. As a result, even if there is no symptom, surgical treatment must be performed to the patients over 50 years of age, with a polyp size over 10 mm, and with cholelithiasis, because of the possibility of malignancy. The cases with polyp size under 10 mm must be followed up with a 6 months period by ult...

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A Useful Approach to the Differential Diagnosis of Small Polypoid Lesions of the Gallbladder, Utilizing an Endoscopic Ultrasound Scoring System

Abstract: The EUS scoring system will be a useful means of differentiating between neoplastic and non-neoplastic polyps of the gallbladder.

Cited by 94 publications

References 15 publications

Management Strategies for Gallbladder Polyps: Is It Possible to Predict Malignant Gallbladder Polyps?

Management Strategies for Gallbladder Polyps: Is It Possible to Predict Malignant Gallbladder Polyps?

Laparoscopic Management of Gall Bladder Polyp

Our surgical experience in gall bladder polyps

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