Abstract

Objectives: Current literature regarding the assessment of changes in gall bladder polyps is minimal in Pakistan, which is known to have one of the highest risk of developing gall bladder carcinoma. The aim of this study is to determine the occurrence of cancer in incidentally detected Gall Bladder (GB) polyps identified by sonography and to propose surveillance guidelines in high risk population for gall bladder cancer. Methods: Radiological data of all “gall bladder polyps” detected on ultrasounds done between January 2001 and February 2015 was taken at a tertiary care institution and it was evaluated to see changes in the size of GB polyps. Pathologic and clinical follow-up was reviewed from the medical record files. Results: GB polyps from 155 patients (Age range, 18–92 years) were included. US follow-up was performed with minimum follow-up duration of 2 years. The polyps ranged in size from 2-19 mm (mean size, 4 mm). Polyp size remained unchanged in 65 (42 %) polyps, decreased in 25 (16 %), increased in 12 (7 %) and resolved in 53 (34%). None of the polyps ranging in size from 1-6 mm turned out to be neoplastic. One polyp of 7 mm showed increase in size and progressed to carcinoma. Conclusion: The risk of malignancy of gall bladder resulting from incidentally detected polyps is very low. Hence, gall bladder polyps measuring upto 6 mm require no additional follow-up. Follow up may be indicated for polyps that are greater than or equal to 7 mm in size. Keywords: Gall bladder cancer, gall bladder polyps, ultrasonography

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