Is Gall-Bladder Polyp Equivalent to Cancer? An Analysis of Material From 1196 Cholecystectomies - A Comparison of the Ultrasound and Histopathological Results

• Authors: Piotr Maciejewski , Janusz Strzelczyk
• Languages of publication: EN

Abstracts

EN

Polyps of the gall-bladder has long been a serious diagnostic problem. Their detection in routine ultrasound is not yet satisfactory and often does not allow you to select the proper method of operating the gall-bladder. The aim of the study was to assess the accuracy of ultrasound diagnosis of polypoid lesions of the gall-bladder through its verification by histopathology in patients treated with cholecystectomy. Material and methods. In the years 2010-2013, 1196 patients underwent surgery due to diseases of the gall-bladder at the Department of General and Transplant Surgery, Medical University in Łódź. The study evaluated the sensitivity of ultrasound in detecting polyps of the gallbladder and histopathological findings of the formulations investigated. Results. Preoperative ultrasound examination (USG) revealed a polypoid lesion in 64 patients; only in 29 of them (44.6%) this diagnosis was confirmed by histopathological examination. In the other cases, cholecystolithiasis or inflammatory lesions were found. The most common histopathological findings included cholesterol polyps, adenomatous polyps, and inflammatory polyps. Malignant lesions (gall-bladder cancer) were found in five patients preoperatively diagnosed with a polypoid lesion, i.e 7.8% of patients preoperatively diagnosed with a polyp and 0.4% of all patients who received surgical treatment. Patients qualified for surgery due to polyps diagnosed by means of ultrasound examination constitued 5.4% of all patients who underwent cholecystectomy. On histopathological examination, the presence of polyps was confirmed in 2.4% patients treated with excision of the gall-bladder. Conclusions. Detection of gall-bladder polyp on ultrasound examination is an indication for cholecystectomy, in particular when the polyp diameter exceeds 10 mm. In each case of a polyp, cholecystolithiasis should also be taken into account and the presence (or absence) of indications for cholecystectomy should be discussed with the patient

Keywords

EN

polyp; gall-bladder; ultrasound; histopathologic score

• Publisher: De Gruyter Open
• Journal: Polish Journal of Surgery
• Year: 2015
• Volume: 86
• Issue: 5
• Pages: 218-222

Dates

published

1 - 5 - 2014

online

1 - 7 - 2014

received

14 - 4 - 2014

Contributors

author

Piotr Maciejewski

• Department of General and Transplant Surgery Barlicki Hospital, Medical University in Łódź, Kierownik: prof. dr hab. J. Strzelczyk

author

Janusz Strzelczyk

• Department of General and Transplant Surgery Barlicki Hospital, Medical University in Łódź, Kierownik: prof. dr hab. J. Strzelczyk

References

• 1. Dacka E., Mąkosa W: Polipy pęcherzyka żółciowego. Gastroenterol Pol 2004; 11 (4): 339-341. ISSN 1232-988.
• 2. Christensen AH, Ishak KG: Benign tumors and pseudotumors of the gall-bladder. Report of 180 cases. Arch Pathol 1970; 90: 423-32.
• 3. Ahrendt SA, Pitt HA: Biliary tract. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, editors. Sabiston textbook of surgery: the biological basis of modern surgical practice. 17th ed. Philadelphia: Elsevier Saunders 2004; pp. 1597-1641.
• 4. Lee KF, Wong J, Li JC, Lai PB: Polypoid lesions of the gall-bladder. Am J Surg 2004; 188: 186-90.
• 5. Boulton RA, Adams DH: Gall-bladder polyps: „When to wait and when to act”. Lancet 1997; 349: 817-19.
• 6. Afzal S, Kristiansen V, Rosenberg J: Galldeblaerepolypper. Ugeskr. Laeger 2001; 163: 5003-06.
• 7. Myers R, Shaffer E, Beck P: Gall-bladder polyps: epidemiology, natural history and management. Can J Gastroenterol 2002; 16: 187-94.[PubMed]
• 8. Okamoto M, Okamoto H, Kitahara F et al.: Ultrasonographic evidence of association of polyps and stones with gall-bladder cancer. Am J Gastroenterol 1999; 94: 446-50.
• 9. Polkowski M: Polipy pęcherzyka żółciowego. Pol Przegl Chir 1995; 67: 858-67.
• 10. Szpakowicz J, Kratochwil M, Wąchol D, Kędra B: Polipy pęcherzyka żółciowego. Pol Przegl Chir 1995; 67: 481-84.
• 11. Bobrzyński A, Budzyński A, Krzywoń J i wsp.: Polip pęcherzyka żółciowego. Wskazanie do cholecystectomii? Pol Przegl Chir 1999; 71: 903-07.
• 12. Azuma T, Y oshikawa T, Araida T, Takasaki K: Differential diagnosis of polypoid lesions of the gall-bladder by endoscopic ultrasonography. Am J Surg 2001; 181: 65-70.
• 13. Huang C, Lien H, Jeng J, Huang S: Role of laparoscopic cholecystectomy in the management of polypoid lesions of the gall-bladder. Surg Laparosc Endosc Percutan Tech 2001; 11: 242-47.[PubMed][Crossref]
• 14. Terzi C, Sökmen S, Seckin S et al.: Polypoid lesions of the gall-bladder: report of 100 cases with special reference to operative indications. Surgery 2000; 127: 622-27.
• 15. Yeh C, Jan Y , Chao T, Chen M: Laparoscopic cholecystecto my for polypoid lesions of the gallbladder: a clinicopathologic study. Surg Laparosc Endosc Percutan Tech 2001; 11: 176-81.[Crossref]
• 16. Collett J, Allan R, Chisholm R et al.: Gall-bladder polyps: prospective study. J U ltrasound Med 1998; 17: 207-11.
• 17. Mainprize K, Gould S, Gilbert J: Surgical management of polypoid lesions of the gall-bladder. Br J Surg 2000; 87: 414-17.
• 18. Jones-Manahan K, Gruenberg J, Finger J, Tong G: Isolated small gall-bladder polyps: an indication for cholecystectomy in symptomatic patients. Am Surg 2000; 66: 716-19.
• 19. Tublin M: Question and anwers. Sonographic follow-up of patients with gall-bladder polyps. Am J Roentgenol 2001; 177: 467-a.
• 20. Tan-Tam C, Chung SW: Minireview on laparoscopic hepatobiliary and pancreatic surgery World J Gastrointest Endosc 2014; 6: 60-67.[Crossref]

Identifiers

DOI

10.2478/pjs-2014-0045