Laparoscopic cholecystectomy in the treatment of gallbladder polypoid lesions – 15 years of experience

• Authors: Maciej Matłok , Marcin Migaczewski , Piotr Major , Michał Pędziwiatr , Piotr Budzyński , Marek Winiarski , Mateusz Ostachowski , Andrzej Budzyński , Kazimierz Rembiasz
• Languages of publication: EN

Abstracts

EN

Due to the constant increase of public health awareness and widespread “cancerophobia”, the progressively larger number of incidentally diagnosed gall-bladder polyps became the source of anxiety, which leads patients and physicians to undertake therapeutic decisions, despite the absence of symptoms. The majority of gall-bladder polyps are benign. It is estimated that only 3 to 5% of polyps are malignant. Currently, there is lack of randomized control trials based on which the clear-cut criteria of qualification of patients with gall-bladder polyps for surgical procedure can be created. The aim of the study was to analyze gall-bladder polyps in patients who underwent laparoscopic cholecystectomy in the 2nd Department of General Surgery, Jagiellonian University Collegium Medicum. Material and methods. The retrospective study was conducted on 5369 patients who underwent laparoscopic cholecystectomy in the 2nd Department of General Surgery, Jagiellonian University Collegium Medicum with special attention to 152 (2.8%) patients in whom gall-bladder polyps were diagnosed preoperatively. Qualification criteria for surgery, surgical treatment results, and histopathological examination results were also analyzed. Results. Amongst the 5369 patients qualified for laparoscopic cholecystectomy, 152 (2.8%) were diagnosed with gall-bladder polyps during the preoperative ultrasound examinations. Postoperative histopathological examinations of 41 (27%) patients confirmed the presence of gall-bladder polyps. In 102 (67%) patients, only gall-stones were diagnosed without previously described polyps during the ultrasound examination. Analysis of the histopathological examination results revealed the presence of benign lesions in 35 (23.35%) patients. In 5 (3%) patients the presence of an adenoma, and in one (0.65%) the presence of adenocarcinoma were confirmed. Conclusions. Based on the conducted study and previous personal experience in the treatment of patients with gall-bladder polyps, we believe that due to the potential risk of neoplastic transformation, patients with polyps larger than 10 mm in diameter and polyps of proven rapid growth should be qualified for laparoscopic cholecystectomy. Indications for surgical treatment also seem reasonable in case of patients with present polyps and coexisting right upper quadrant pain, even though the above-mentioned is connected with gall-bladder deposits.

Keywords

EN

gall-bladder polyps; laparoscopic cholecystectomy; gall-bladder cancer; gall-bladder ultrasound

• Journal: Polish Journal of Surgery
• Year: 2013
• Volume: 85
• Issue: 11
• Pages: 625-629

Dates

published

1 - 11 - 2013

online

31 - 12 - 2013

Contributors

author

Maciej Matłok

• 2nd Department of General Surgery, Jagiellonian University Collegium Medicum in Cracow

author

Marcin Migaczewski

• 2nd Department of General Surgery, Jagiellonian University Collegium Medicum in Cracow

author

Piotr Major

• 2nd Department of General Surgery, Jagiellonian University Collegium Medicum in Cracow

author

Michał Pędziwiatr

• 2nd Department of General Surgery, Jagiellonian University Collegium Medicum in Cracow

author

Piotr Budzyński

• 2nd Department of General Surgery, Jagiellonian University Collegium Medicum in Cracow

author

Marek Winiarski

• 2nd Department of General Surgery, Jagiellonian University Collegium Medicum in Cracow

author

Mateusz Ostachowski

• Students’ Society of Science, 2nd Department of General Surgery, Jagiellonian University Collegium Medicum in Cracow

author

Andrzej Budzyński

• 2nd Department of General Surgery, Jagiellonian University Collegium Medicum in Cracow

author

Kazimierz Rembiasz

• 2nd Department of General Surgery, Jagiellonian University Collegium Medicum in Cracow

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Identifiers

DOI

10.2478/pjs-2013-0094