Late Follow-Up of Polypoid Lesions of the Gallbladder Smaller Than 10 mm

Abstract

ObjectiveTo determine the variation in number, size, and symptoms in patients with polypoid lesions of the gallbladder. Summary Background DataA polypoid lesion is any elevated lesion of the gallbladder mucosa. Several studies have been reported in patients undergoing cholecystectomy, but little information exits regarding the natural history of these lesions in nonoperated patients. MethodsA total of 111 patients with ultrasound diagnosis of polypoid lesions smaller than 10 mm were followed up by clinical evaluation and ultrasonography. Twenty-seven patients underwent cholecystectomy. ResultsThere was no difference in terms of gender. Nearly 80% of the lesions were smaller than 5 mm; they were single in 74%. In nonoperated patients, 50% remained of similar size at the late follow-up, 26.5% increased in number and size, and 23.5% shrank or disappeared. Among the operated patients, 70% corresponded to cholesterol polyps. None of the patients developed symptoms of biliary disease or gallstones or adenocarcinoma. ConclusionsUltrasound is useful in the follow-up of patients with polypoid lesions of the gallbladder. Lesions smaller than 10 mm do not progress to malignancy or to development of stones, and none produced symptoms or complications of biliary disease.

Expression of p16 protein and cyclin d1 in periampullary carcinomas

“…The detection rate for these lesions has increased with the widespread use of USG in recent years, but it is difficult to define the biologic nature of them radiologically (18). it is suggested that sessile polyps, those are echopenic at USG, with a diameter of greater than 10 mm (2,17,19,20) and associated with gallstones (17,21) are highly suspicious for malignancy and should be removed, whereas asymptomatic patients with polyps smaller than 10 mm are subject to follow-up (20). However, roa et al (3) reported two adenomas less than 5 mm in length and associated with adenocarcinoma in their series and claimed that polyp size criteria to decide on surgical intervention may be misleading.…”

Decision for surgery in the management of a rare condition, childhood gallbladder polyps, and the role of ultrasonography

“…arly 30 cases of gallbladder adenoma in a polyp less than 10 mm of diameter have been reported in the literature (19,20). This is another evidence supporting the necessity for follow-up in these cases.…”

Our surgical experience in gall bladder polyps

“…Çalışmamızdaki yalancı pozitiflik oranı %2.8 olarak saptanmış ve bu pozitifliğin duvara impakte olmuş bir taştan kaynaklandığı histopatolojik incelemede ortaya çıkmıştır. Ancak bazı teorilerde, çok ince saplı poliplerin safra akışı sırasında kopup kaybolabildiği de ifade edilmektedir (6,11).…”

“…'nın (6) yapmış olduğu bir çalışmada ise polibi olan 98 hastanın 6 yıllık takip sürecinde, hastaların %50'sinde polip boyutları sebat ederken %25'inde boyutlarda artma saptanmıştır. Boyutlarında artma saptanan hastalardan sadece bir tanesinde adenomatöz polip saptanmış olup diğerleri ise kolesterol polipi olarak raporlanmıştır (6). Bizim çalışmamızda da sadece bir hastanın histopatolojik inceleme sonucunda adenomatöz polibe rastlanmıştır.…”

“…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).…”