Ultrasonographic Evidence of Association of Polyps and Stones With Gallbladder Cancer

Okamoto, Masako; Okamoto, Hiroyuki; Kitahara, Fumiaki; Kobayashi, Kazuhisa; Karikome, Kazuhiro; Miura, Kazuo; Matsumoto, Yoshirô; Fujino, Masayuki

doi:10.1111/j.1572-0241.1999.875_d.x

Cited by 111 publications

(56 citation statements)

References 15 publications

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“…15 Lesions that did not fulfill all of these criteria were not diagnosed as GB polyps. We tried to categorize subjects under USG into 5 different groups according to characteristics of USG findings that were documented by Okamoto's study in 1999, 14 group A, no abnormal findings; group B, benign lesions such as polypoid lesion (diameter ＜5 mm), cornet-like echo, or GB swelling, which were followed-up once/yr; group C, benign lesions, such as polypoid lesion (5 mm ≤ diameter ＜10 mm), strong echo within the GB, or slight wall thickness of the GB, group D, benign lesion, but one in which malignancy could not be ruled out, such as polypoid lesion (diameter ≥10 mm), mass formation, debris, atrophic GB, or severe wall thickening of the GB, group E, suspected malignancy or malignancy, many of which were polypoid lesions with irregularity or heterogeneity, or with irregular wall thickness of the GB. In addition, we categorized shapes of GB in three different groups; papillary, sessile, and pedunculated polyps.…”

Section: Diagnosis Of Gb Polypmentioning

confidence: 99%

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: Diagnosis Of Gb Polypmentioning

confidence: 99%

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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“…Occurrence of gall-bladder cancer in patients with cholecystolithiasis may suggest an association between this condition and the presence of polyps, and, in consequence, increased risk of cancer (8).…”

Section: Discussionmentioning

confidence: 99%

“…In adult population, polyps are detected in 1.5-5.5% of individuals. In a screening study that enrolled over 190,000 individuals, polyps were detected in 6.9% of men and 4.5% of women (7,8).…”

Section: Discussionmentioning

confidence: 99%

Is Gall-Bladder Polyp Equivalent to Cancer? An Analysis of Material From 1196 Cholecystectomies - A Comparison of the Ultrasound and Histopathological Results

Maciejewski¹,

Strzelczyk²

2014

Polish Journal of Surgery

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Polyps of the gall-bladder has long been a serious diagnostic problem. Their detection in routine ultrasound is not yet satisfactory and often does not allow you to select the proper method of operating the gall-bladder. the aim of the study was to assess the accuracy of ultrasound diagnosis of polypoid lesions of the gall-bladder through its verification by histopathology in patients treated with cholecystectomy. material and methods. In the years 2010-2013, 1196 patients underwent surgery due to diseases of the gall-bladder at the Department of General and Transplant Surgery, Medical University in Łódź. The study evaluated the sensitivity of ultrasound in detecting polyps of the gallbladder and histopathological findings of the formulations investigated. Results. Preoperative ultrasound examination (USG) revealed a polypoid lesion in 64 patients; only in 29 of them (44.6%) this diagnosis was confirmed by histopathological examination. In the other cases, cholecystolithiasis or inflammatory lesions were found. The most common histopathological findings included cholesterol polyps, adenomatous polyps, and inflammatory polyps. Malignant lesions (gall-bladder cancer) were found in five patients preoperatively diagnosed with a polypoid lesion, i.e 7.8% of patients preoperatively diagnosed with a polyp and 0.4% of all patients who received surgical treatment. Patients qualified for surgery due to polyps diagnosed by means of ultrasound examination constitued 5.4% of all patients who underwent cholecystectomy. On histopathological examination, the presence of polyps was confirmed in 2.4% patients treated with excision of the gall-bladder. conclusions. Detection of gall-bladder polyp on ultrasound examination is an indication for cholecystectomy, in particular when the polyp diameter exceeds 10 mm. In each case of a polyp, cholecystolithiasis should also be taken into account and the presence (or absence) of indications for cholecystectomy should be discussed with the patient.

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“…Polypoid lesions of the gallbladder (PLGs), are defined as immobile echoes protruding from the gallbladder wall into the lumen by ultrasonography (US), and the mass lesions occurred as a result of protrusion from the wall to the inside of the gallbladder, regardless of neoplastic potential (1). PLGs are often diagnosed incidentally following a routine abdominal ultrasound or cholecystectomy for other reasons as gallstones or biliary colic (1)(2)(3).…”

Section: Introductionmentioning

confidence: 99%

“…PLGs are often diagnosed incidentally following a routine abdominal ultrasound or cholecystectomy for other reasons as gallstones or biliary colic (1)(2)(3). The prevalence of PLGs in healthy people according to US findings is reported as 4.0-5.6%.…”

Section: Introductionmentioning

confidence: 99%

Is it necessary to perform prophylactic cholecystectomy for all symptomatic gallbladder polyps diagnosed with ultrasound?

et al. 2017

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Objective:The main aim of this study is to determine the necessity of cholecystectomy in patients with ultrasound diagnosed symptomatic polypoid lesions of the gallbladder. Material and Methods:The data of 82 patients with polypoid lesions of the gallbladder who had cholecystectomy between 2000 and 2012 were analyzed retrospectively with preoperative ultrasound and histopathology results. Results:The mean age was 48.05±11.18 years (range 25-74 years). All patients underwent preoperative ultrasound examination. Eighteen (22%) of the 82 patients were asymptomatic; their polypoid lesions of the gallbladder were detected with ultrasound during a check-up or other reasons. In 45 (55%) of cases pathology reported no polypoid lesions of the gallbladder. Right upper quadrant or epigastric pain was the most common symptom (41.46%) that led to hepatobiliary ultrasound, the other symptom was dyspepsia (36.59%). On preoperative ultrasound evaluation, 22 patients had multiple polyps, and 9 of these 22 patients had at least 3 polyps. Conclusion:There is an inaccuracy of ultrasound to detect polypoid lesions of the gallbladder. After diagnosing polypoid lesions of the gallbladder by using standard ultrasound, further pre-operative diagnostic tests are needed to help discriminating benign lesions from malignant ones, which may prevent unnecessary surgery regardless of symptoms.

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Ultrasonographic Evidence of Association of Polyps and Stones With Gallbladder Cancer

Abstract: These results suggest an association between gallstone or polyp of the gallbladder and increased risk of malignancy, implying that an etiological association may also exist.

Cited by 111 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?

Is Gall-Bladder Polyp Equivalent to Cancer? An Analysis of Material From 1196 Cholecystectomies - A Comparison of the Ultrasound and Histopathological Results

Is it necessary to perform prophylactic cholecystectomy for all symptomatic gallbladder polyps diagnosed with ultrasound?

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