When should gallbladder polyps be treated surgically?

Şahiner, İbrahim Tayfun; Dolapci, Mete

doi:10.17219/acem/75678

Cited by 15 publications

(9 citation statements)

References 10 publications

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“…По мнению различных исследователей и проведённых метаанализов, факторами риска развития полипов желчного пузыря считают следующие: мужской пол, повышение индекса массы тела, сахарный диабет, табакокурение, повышение уровня общего холестерина, триглицеридов, ЖКБ, носительство HBsAg [36], что, однако, не является патогномоничными причинами и требует дальнейших исследований. Разница по гендерному признаку несущественна и составляет 54,9 % у женщин, и 45,1 % у мужчин [9], схожие результаты в исследовании Sun Y: мужчин -44,2 %, женщин -55,8 % [32], что подтверждают и другие исследования. Однако мужчины в 4 раза чаще страдают полипозным холестерозом, а женщины -в 8 раз чаще гиперпластическими полипами и аденомами желчного пузыря [3].…”

Section: этиология и клиническая картинаunclassified

“…Однако мужчины в 4 раза чаще страдают полипозным холестерозом, а женщины -в 8 раз чаще гиперпластическими полипами и аденомами желчного пузыря [3]. Ряд авторов отмечают увеличение частоты возникновения полиповидных образований желчного пузыря прямо пропорционально возрасту [12,18,27,31,32]. Клиническая картина полипов желчного пузыря неспецифична, и зачастую отсутствует [2].…”

Section: этиология и клиническая картинаunclassified

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Gallbladder polyps: diagnosis and treatment tactics (literature review)

Переходов

Nikolaev

Saidov

2021

jour

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Gallbladder polyps are an elevation of the mucous membrane that protrudes into the lumen of the gallbladder cavity. Pathology, according to world literature, occurs with a frequency of 0.3% to 13.8%. Currently, the diagnosis of polypoid formations of the gallbladder is based on the routine use of ultrasound, without further clarifying research, which often leads to errors in treatment tactics. In the domestic literature, there are very few studies on this topic, despite the relevance of this area.

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Section: этиология и клиническая картинаunclassified

Gallbladder polyps: diagnosis and treatment tactics (literature review)

Переходов

Nikolaev

Saidov

2021

jour

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“…With the development of high-resolution ultrasound equipment and increased frequency of periodic health examinations, numerous gallbladder polyps are now diagnosed at an early phase. Although the reported incidence rate in adults is~0.3–12.3%, only about 5% of polyps are true polyps ( 1 , 2 ). Postoperative pathological gallbladder polyp types include cholesterol polyps, inflammatory polyps, adenomyomas, adenomas, and early gallbladder cancer.…”

Section: Introductionmentioning

confidence: 99%

“…Although the reported incidence rate in adults is∼0. 3-12.3%, only about 5% of polyps are true polyps (1,2). Postoperative pathological gallbladder polyp types include cholesterol polyps, inflammatory polyps, adenomyomas, adenomas, and early gallbladder cancer.…”

Section: Introductionmentioning

confidence: 99%

Ultrasound Radiomics Effective for Preoperative Identification of True and Pseudo Gallbladder Polyps Based on Spatial and Morphological Features

Yuan

Zhang

et al. 2020

Front. Oncol.

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Purpose: To explore the value of ultrasound radiomics in the preoperative identification of true and pseudo gallbladder polyps and to evaluate the associated diagnostic accuracy. Methods: Totally, 99 pathologically proven gallbladder polyps in 96 patients were enrolled, including 58 cholesterol polyps (55 patients) and 41 gallbladder tubular adenomas (41 patients). Features on preoperative ultrasound images, including spatial and morphological features, were acquired for each lesion. Following this, two-stage feature selection was adopted using Fisher's inter-intraclass variance ratios and Z-scores for the selection of intrinsic features important for differential diagnosis achievement with support vector machine use. Results: Eighty radiomic features were extracted from each polyp. Eight intrinsic features were identified after two-stage selection. The contrast 14 (Cont14) and entropy 6 (Entr6) values in the cholesterol polyp group were significantly higher than those in the gallbladder adenoma group (4.063 ± 1.682 vs. 2.715 ± 1.867, p < 0.001 for Cont14; 4.712 ± 0.427 vs. 4.380 ± 0.720, p = 0.003 for Entr6); however, the homogeneity 13 (Homo13) and energy 8 (Ener8) values in the cholesterol polyp group were significantly lower (0.500 ± 0.069 vs. 0.572 ± 0.057, p < 0.001 for Homo13; 0.050 ± 0.023 vs. 0.068 ± 0.038, p = 0.002 for Ener8). These results indicate that the pixel distribution of cholesterol polyps was more uneven than that of gallbladder tubular adenomas. The dispersion degree was also significantly lower in the cholesterol polyp group than the gallbladder adenoma group (0.579 ± 0.054 vs. 0.608 ± 0.041, p = 0.005), indicating a lower dispersion of high-intensity areas in the cholesterol polyps. The long axis length of the fitting ellipse (Maj.Len), diameter of a circle equal to the lesion area (Eq.Dia) and perimeter (Per) values in the cholesterol polyp group were significantly lower than those in the gallbladder adenoma group (0.971 ± 0.485 vs. 1.738 ± 0.912, p < 0.001 for Maj.Len; 0.818 ± 0.393 vs. 1.438 ± 0.650, p < 0.001 for Eq.Dia; 2.637 ± 1.281 vs. 5.033 ± 2.353, p < 0.001 for Per), demonstrating that the cholesterol polyps were smaller and more regular in terms of morphology. The classification accuracy, sensitivity, specificity, and area under the curve values were 0.875, 0.885, 0.857, and 0.898, respectively. Conclusions: Ultrasound radiomic analysis based on the spatial and morphological features extracted from ultrasound images effectively contributed to the preoperative diagnosis of true and pseudo gallbladder polyps and may be valuable in their clinical management.

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“…), у 1/3 пациентов с полипами Жп клинические симптомы отсутствовали. часть пациентов с полипами Жп обращались с жалобами на: дискомфорт в правом верхнем квадранте живота (59,3%); боль в правом верхнем квадранте (18,2%); тошноту/рвоту (11,9%), непереносимость пищи (10,6%) [20]. по данным ретроспективного анализа 686 пациентов с подтвержденными полипами Жп после холецистэктомии, из 522 лиц с холестериновыми полипами у 254 человек симптомы отсутствовали, 122 -беспокоил абдоминальный дискомфорт, 141 -абдоминальная боль.…”

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Gallbladder polyps: modern approaches to diagnostics and treatment

Онучина

2021

Terapevticheskii arkhiv

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Gallbladder polyps are an elevation of the mucous membrane that protrudes into the lumen of the gallbladder cavity. Their prevalence in the general population varies from 0.3 to 13.8%. According to the modern classification, polyps of the gallbladder are divided into benign non-tumor, benign tumor and malignant tumor polyps. A review of modern literature presents cohort and randomized controlled trials, including those summarized in meta-analyzes and systematic reviews, suggesting that the dominant form of polypoid formations of the gallbladder are cholesterol pseudo-polyps with no malignant potential associated with impaired cholesterol metabolism, often combined with gallbladder cholesterosis, metabolic syndrome and cardiovascular morbidity. Evidence is building up on the effectiveness of ursodeoxycholic acid for controlling components of the metabolic syndrome and cardiovascular risks. Ursodeoxycholic acid preparations may become promising for the management of cholesterol polyps.

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When should gallbladder polyps be treated surgically?

Abstract: In patients over 50 years of age with co-existent cholelithiasis and GP exceeding 10 mm, surgical treatment should be undertaken due to the risk of malignancy. Other patients with polyps less than 10 mm in size should be followed up in 6-month intervals using ultrasound examination.

Cited by 15 publications

References 10 publications

Gallbladder polyps: diagnosis and treatment tactics (literature review)

Gallbladder polyps: diagnosis and treatment tactics (literature review)

Ultrasound Radiomics Effective for Preoperative Identification of True and Pseudo Gallbladder Polyps Based on Spatial and Morphological Features

Gallbladder polyps: modern approaches to diagnostics and treatment

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