Diagnosis and Surgical Indications for Polypoid Lesions of the Gallbladder

Abstract

To clarify the surgical indications for polypoid lesions of the gallbladder (PLG), we studied 62 patients who underwent cholecystectomy with the preoperative diagnosis of PLG. This included cholesterol polyps in 49 patients, adenomas in 2 patients, hyperplastic polyps in 1 patient, inflammatory polyps in 1 patient and adenocarcinomas in 9 patients. The maximum size of the benign lesions was 15 mm and all larger PLG were malignant. In contrast to cholesterol polyps, which tended to be multiple, gallbladder cancers typically occurred as single polyps in older patients. Three patients had cancers less than 15 mm in size (minimum 6 mm), all of which were pedunculated and could not be distinguished from cholesterol polyps by ultrasonography. In conclusion, PLG greater than 15 mm are indications for surgery. For PLG ranging from 6 to 15 mm in size, surgical treatment should be performed when the lesion is single, when the patient is old, when gallstones coexist.