Treatment Guidelines for Gallbladder Polyps

Article information

J Korean Med Assoc. 2006;49(5):423-429
Publication date (electronic) : 2006 May 31
doi : https://doi.org/10.5124/jkma.2006.49.5.423
Department of Internal Medicine, Kyung Hee University College of Medicine & Hospital, Korea. gidrdong@chol.com

Abstract

Polypoid lesions of the gallbladder affect approximately 5% of the adult population. Most affected individuals are asymptomatic, and their gallbladder polyps are detected during abdominal ultrasonography performed for unrelated conditions. Most of these lesions are benign and small sized cholesterol polyps. Yet the surgery is the only way to confirm whether the polyp is benign or not. The most important factors to predict malignancy are the size of the polyp and the patients' age. Most of the polyps less than 10 mm are considered as benign. Ultrasonographic examinations at three-to six-month intervals are warranted to detect rapid growing polyps that should be considered as malignant. However, the imaging follow-up is probably not necessary after 1 or 2 years if there was no increase in the size of the polyp during the initial follow-up period. For polyps greater than 10 mm in diameter, sessile polyps, or patients over 50 years of age, laparoscopic cholecystectomy should be recommended. Polyps associated with symptoms or gallstones are also the indications of surgery.

References

1. Lee KF, Wong J, Li JC, Lai PB. Polypoid lesions of the gallbladder. Am J Surg 2004. 188186–190.
2. Moriguchi H, Tazawa J, Hayashi Y, Takenawa H, Nakayama E, Sato C, et al. Natural history of polypoid lesions in the gallbladder. Gut 1996. 39860–862.
3. Csendes A, Burgos AM, Csendes P, Smok G, Rojas J. Late follow-up of polypoid lesions of the gallbladder smaller than 10 mm. Ann Surg 2001. 234657–660.
4. Kozuka S, Tsubone N, Yasui A, Hachisuka K. Relation of adenoma to carcinoma in the gallbladder. Cancer 1982. 502226–2234.
5. Yang HL, Sun YG, Wang Z. Polypoid lesions of the gallbladder: diagnosis and indications for surgery. Br J Surg 1992. 79227–229.
6. Kubota K, Bandai Y, Noie T, Ishizaki Y, Teruya M, Makuuchi M. How should polypoid lesions of the gallbladder be treated in the era of laparoscopic cholecystectomy? Surgery 1995. 117481–487.

Article information Continued

Figure 1

The frequency distribution of gallbladder polyps in Korean (Shim SG, et al. Korean J Med 1999)

Figure 2

Treatment algorithm of polypoid lesions of the gallbladder (Boulton RA, Adams DH. Lancet 1997)

Table 1

Benign tumors and pseudotumors of gallbladder (Christensen AH, Ishak KG. Arch Pathol 1970)

Table 1

Table 2

Types of polypoid lesions of gallbladder in a review of 172 cases (Yang HL. Br J Surg 1992)

Table 2