A Surgical Consideration on Gallbladder Polyp - A Proposal of Therapeutic Guideline for Gallbladder Polyp -

Cho, Yong Kyun; Park, Chang Young; Shin, Jun Ho

Abstract

BACKGROUND/AIMS: The aim of this study was to establish the appropriate treatment standard for gallbladder polyp by analyzing gross and microscopic appearance of gallbladder polyp as well as clinical finding.
METHODS
Among 982 subjects who underwent laparoscopic cholecystectomy due to gallbladder pathology, 82 subjects were confirmed to have gallbladder polyps by tissue pathology. To confirm the surgical indication of polyps with malignancy potential, we analyzed 82 cases for sex, age, clinical symptoms, polyp size, numbers, shape, coexistence of gallbladder stone, and tissue pathologic findings.
RESULTS
Malignancy of polyps were frequently observed among old patients in sixth and seventh decades. The mean age of patients with malignant polyps was 59.1+/-5.0. The size of malignant polyp was relatively large (25.6+/-5.9 mm) and most of them existed as single polyp. The size of malignant polyps was over 10 mm regardless of the shape of the polyp (pedunculated or sessile).
CONCLUSIONS
On the basis of our analysis, in the case that the polyp is single type and over 20 mm, operation is required because of the high risk of malignancy. For the case that the tumor size is around 10 mm, we recommend to remove the polyp when no contraindication is observed. If surgery is not feasible, a close follow-up is generally recommended to monitor the change in size.