Is it necessary to perform prophylactic cholecystectomy for asymptomatic subjects with gallbladder polyps and gallstones?

Choi, Sung Youn; Kim, Tae Sun; Kim, Hong Joo; Park, Jung Ho; Park, Dong Il; Cho, Yong Kyun; Sohn, Chong Il; Jeon, Woo Kyu; Kim, Byung Ik

doi:10.1111/j.1440-1746.2010.06288.x

Cited by 28 publications

(21 citation statements)

References 13 publications

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“…In general, the findings of this study agree with those of previous reports, in particular the observation that initial size greater than 10 mm and subsequent growth on interval scanning predicts neoplas-tic or potentially neoplastic polyps. [22][23][24][25][26] In addition, the results are in accordance with other observations regarding the very low rate of true polyps and malignant polyps in patients with sonographic mucosal abnormalities consistent with possible polyps [22][23][24][25][26] ; further refinements have attempted to correlate the rate of growth with neoplastic potential. 27 The relatively small number of patients (n=134) who underwent surgery also requires consideration when interpreting the validity of the results.…”

Section: Caveatssupporting

confidence: 89%

Risk and Cost-effectiveness of Surveillance Followed by Cholecystectomy for Gallbladder Polyps

Cairns¹,

Neal²,

Dennison³

et al. 2012

Arch Surg

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Main Outcome Measures: Demographic data and size and number of polyps were recorded as well as size increase and histological findings. Detection rates for potentially neoplastic and frankly neoplastic polyps were recorded and compared with complication rates from cholecystectomy. Cost-effectiveness of ultrasonography surveillance was examined. Results: Nine hundred eighty-six patients were identified and 467 patients underwent further follow-up. Only 6.6% of polyps exhibited an increase in size over the surveillance period. Polyps that subsequently progressed in size on surveillance had a significantly greater diameter at first presentation than those polyps that remained static (7 mm vs 5 mm, respectively) (PϽ.05). Only 3.7% of resected polyps had malignant or potentially malignant histology. Size greater than 10 mm and increase in size during surveillance predicted neoplastic potential. Conclusions: A surveillance with or without selective surgery policy could potentially detect and prevent 5.4 gallbladder cancers per 1000 individuals per year with a cost saving of more than £130 000 (US $201 676) per year. Cancer prevention benefits would exceed the risk ratios from cholecystectomy complications. Polyps greater than 10 mm should be resected; those between 5 and 10 mm should be under ultrasonography surveillance.

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Section: Caveatssupporting

confidence: 89%

Risk and Cost-effectiveness of Surveillance Followed by Cholecystectomy for Gallbladder Polyps

Cairns¹,

Neal²,

Dennison³

et al. 2012

Arch Surg

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“…There was, therefore, no significant difference in delta polyp size between the examinees with gallbladder polyps and cholelithiasis and those with gallbladder polyps only. [11]…”

Section: Relation Between Gallbladder Stones and Gallbladder Polypsmentioning

confidence: 99%

Diagnosis and Management of Gallbladder Polyps

2012

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Gallbladder cancer is a rather uncommon disease, when it gives symptoms it has usually reached an incurable stage. Therefore, every attempt must be made to find the asymptomatic stages and look for premalignant gallbladder polyps. Even if gallbladder cancer is a rare disease, gallbladder polyps are common, only a few polyps develop to cancer. This makes gallbladder polyps another problem: which are the polyps that must be surgically removed, which shall be followed-up, or for how long? The author used the keyword “gallbladder polypsn” in PubMed and reviewed the scientific literatures published from January 2000 to December 2011. The present review article has summarized almost all respects of gallbladder polyp, including the risk factors, clinical diagnosis and management, and comments made from the author, in which clinical treatments are recommended. It is author's purpose that the 11-year-knowledge about gallbladder polyps summarized from all worlds’ literatures is enough to know how clinicians will handle the next patient with gallbladder polyp.

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“…El detectar pólipos en 73 o 74 personas de cada 100 casos atendidos, indica la importancia de seguir utilizando este método diagnóstico, pues la mayoría de las instituciones de salud cuenta con un equipo ecográfico, por la accesibilidad en cuanto a costos y por ser un procedimiento no invasivo. Además, la ecografía permite visualizar la pared vesicular y el seguimiento de los pólipos en cuanto al tamaño que son aspectos básicos para realizar colecistectomía profiláctica (30).…”

Section: Discussionunclassified

Correlación entre diagnóstico ecográfico e histopatológico de poliposis vesicular en la Clínica Good Hope 2008-2014

Castro¹,

Fernández²,

Castro³

et al. 2016

HorizMed

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Determinar la correlación entre el diagnóstico ecográfico y el resultado histopatológico de poliposis vesicular en los pacientes y encontrar el valor predictivo positivo de la ecografía en el diagnóstico de esta patología. Material y Métodos: Es una investigación no experimental, transversal, descriptiva y correlacional, realizada en una muestra de 128 pacientes operados con diagnóstico de poliposis vesicular en la clínica Good Hope entre 2008 y 2014. Se revisaron los informes ecográficos e histopatológicos de estos pacientes y se buscó la relación mediante el coeficiente de correlación de Spearman. Resultados: El 67,2% de la muestra correspondió al sexo femenino y el 32,8% al sexo masculino; la edad promedio fue de 43,4 años. El 74,2% de los 128 casos presentó pólipos según el examen histopatológico, de los cuales el 94,7% fueron pseudopólipos y 84% fueron pólipos de colesterol; solo el 5,3% de los pólipos fueron verdaderos (adenomas) y ninguno de ellos fue maligno, el pólipo más grande midió 13 mm. El valor predictivo positivo de la ecografía en el diagnóstico de poliposis vesicular fue 74.21%. La correlación entre el número de pólipos por ecografía e histopatología según el coeficiente de Spearman fue muy baja, directa y significativa (Rho=0,189, p=0,032). Conclusión: Existe una correlación directa entre el diagnóstico ecográfico y el resultado histopatológico de poliposis vesicular; la ecografía puede considerarse como un método confiable para el diagnóstico de esta patología.

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Is it necessary to perform prophylactic cholecystectomy for asymptomatic subjects with gallbladder polyps and gallstones?

Cited by 28 publications

References 13 publications

Risk and Cost-effectiveness of Surveillance Followed by Cholecystectomy for Gallbladder Polyps

Risk and Cost-effectiveness of Surveillance Followed by Cholecystectomy for Gallbladder Polyps

Diagnosis and Management of Gallbladder Polyps

Correlación entre diagnóstico ecográfico e histopatológico de poliposis vesicular en la Clínica Good Hope 2008-2014

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