Surgical treatment strategy of gallbladder polyps based on high risk factors of gallbladder cancer

Abstract

In order to prevent the canceration of gallbladder polyps or avoid the misdiagnosis of gallbladder cancer, the mainstream practice is cholecystectomy for polyps larger than 1 cm, while gallbladder polyps larger than 0.5 cm as an indication of gallbladder preserving surgery. The reasons for this result is that we put the diameter of more than 1 cm of gallbladder polyps as high risk factors for prediction of gallbladder carcinoma, and we ignored the characteristics of gallbladder polyps that most of them are not gallbladder cancer or are not cancerous even larger than 1 cm. We analysed the high risk factors for gallbladder cancer on the basis of variety of clinical data, and we believe that the most valuable indicator of gallbladder cancer are the growth time of gallbladder polyps, the age of the patients, the combination of gallstones, the single polyps, and the sex. Polyps diameter greater than 1 cm are not a high risk factor for gallbladder cancer. We can use these five high risk factors to manage gallbladder polyps and reduce unnecessary cholecystectomy and gallbladder preserving surgery. Key words: Gallbladder polyps; Gallbladder cancer; High risk factors; Cholecystectomy; Over-treatment