Laparoscopic Cholecystectomy for Polypoid Lesions of the Gallbladder

Lee, Jae Seol; Choi, In Seok; Yea, Byung Kook; Sim, Mun Sup

Abstract

BACKGROUND/AIMS: The size and number of gallbladder polyps are used to differentiate between benign and malignant lesions before surgery. The objective of this study was to determine which polyps of the gallbladder should be operated upon and whether laparoscopic cholecystectomy is a safe and feasible method for gallbladder polypoid lesions of the gallbladder.
METHODS
Data from 68 patients with polypoid lesions of the gallbladder treated by laparoscopic cholecystectomy at the Department of surgery, Pusan National University Hospital were reviewed retrospectively. the gallbladders were classified into four histologic groups. Clinical features, maximal diameter, and the number of lesions were compared among the groups.
RESULTS
The mean maximal diameter of neoplasms was significantly larger than that of lesions in the nonneoplasm group. All four malignant lesions that were detected measured at least 1.5 cm. Univariate analysis showed that polypoid lesions of the gallbladder with neoplastic lesion correlated significantly with age, sex, and number of the lesions. Univariate analysis also showed that malignancy in polypoid lesions of the gallbladder correlated significantly with age, size, and number of the lesions. Multivariate logistic regression analysis showed that the age of the patient and the size of the lesion (> or =1.0 cm) are two independent factors in predicting neoplastic lesions in polypoid lesions of the gallbladder. The size of the lesion (> or =1.5 cm) is the only independent factor in predicting malignancy in the polypoid lesions of the gallbladder as shown by multivariate logistic regression analysis.
CONCLUSION
Laparoscopic cholecystectomy is a safe and feasible method for gallbladder polypoid lesions. Neoplastic change in polypoid lesions of the gallbladder should be considered when a patient older than 50 years of age has a polypoid lesion larger than 1.0 cm. Cancer should be suspected when a polypoid lesion of the gallbladder is larger than 1.5 cm.