Management of polypoid lesions of the gallbladder: an analysis of 748 patients

Abstract

Objective To investigate the risk factors of gallbladder neoplastic polyps,to determine the proper surgical indications,and to understand more about the clinical characteristics of gallbladder adenoma.Methods The clinical data of 748 patients diagnosed to have polypoid lesion of gallbladder (PLG) and underwent cholecystectomy from January 1998 to December 2012 in the Second Affiliated Hospital of Zhejiang University School of Medicine were retrospectively reviewed.Results Among 748 patients,340 had abdominal symptoms.Postoperative histopathology showed non-neoplastic polyps (n =659),gallbladder adenoma (n =68),gallbladder cancer (n =15) and no polyps (n =6).The mean diameters of the nonneoplastic lesions and the neoplastic polyps were (9.38 ± 3.44) mm and (14.55 ± 5.71) mm,respectively (P ＜ 0.01).The average age of the patients with non-neoplastic lesions was (44.14 ± 11.42) years and (47.39 ± 12.82) years in those with neoplastic polyps (P ＜ 0.05).The proportion of solitary PLG was 41.4％ (253/611) and 59.59％ (47/79) for the non-neoplastic lesions and the neoplastic polyps respec tively (P ＜ 0.01).The size of PLG (13.34 ± 4.18 mm vs.20.07 ± 8.19 mm,P ＜ 0.05) and the age of the patient (45.78 ± 11.66 years vs.54.13 ± 15.82 years,P ＜0.05) between the gallbladder adenoma and gallbladder cancer groups were significantly different.Gallbladder adenoma or dysplasia was identified in 66.7％ (10/15) of gal1bladder cancer specimens.Conclusions Patients with PLG and with abdominal symptoms,large size (≥ 10 mm),old age (≥50 y) and solitary polyp are indications for cholecystectomy.Gallbladder adenoma may develop to gallbladder cancer within 10 years. Key words: Gallbladder diseases ; Polyps ; Gallbladder neoplasms