Postoperative Histopathology Findings of Ultrasonographically diagnosed Gallbladder Polyp In 32 Patients.

Abstract

Background/Objective: ‘Polypoid lesions of gallbladder‘ (PLGs) are common incidental finding on ultrasound examinations of the abdomen. The optimal management of PLGs is ill-defined and controversial. The aim of this retrospective study is to assess the post-surgery histopathology findings of PLGs. Materials And Methods: Clinical and histopathological data of patients who had cholecystectomies, open or laparoscopic, from June 2004 to June 2009 at Patan Hospital, PAHS for PLGs detected by USG were analyzed retrospectively. Results: Out of total 32 USG diagnosed PLGs, one (3%) did not have polyp in surgical specimen. Remaining 31 cases were analyzed. Of 31 cases, 22 (71%) were female. Average age was 40 years (22 to 69 years) and 23 (74%) were over 50 years. Histopathology revealed 26 patients (84%) had pseudo polyps (cholesterosis, cholesterol or inflammatory polyps) and 5 true polyps of which 2 were malignant. 24 (77%) patients had polyps equal to or smaller than 5 mm, 3 were 6-10 mm and 4 were >10 m. 26 (84%) had single polyp. In 14 patients (45%) stone was present together with polyps. All 5 neoplastic polyps were over >= 5 mm and only one was suspicious of malignancy (a 30 mm polypoid adenocarcinoma) on USG, while another 5 mm adenocarcinoma was reported as benign preoperatively. All patients had uneventful postoperative recovery. Conclusion: Histopathology analysis of PLGs is the gold standard to identify malignancy. Ultrasound has been used extensively in the pre-operative management of these lesions, but is unable to differentiate between benign and malignant PLGs with certainty. Surgical intervention should be considered in PLGs ≥5 mm detected by USG and in whom long-term follow-up cannot be completed.